ECE2021 Audio Eposter Presentations Adrenal and Cardiovascular Endocrinology (80 abstracts)
Biomarkers of cardiovascular disease and inflammation in autoimmune addison’s disease with residual adrenocortical function
Åse Bjorvatn Sævik1, 2, Anna-Karin Åkerman1, 3, 4, Paal Methlie1, 2, 5, Marcus Quinkler6, Anders Jørgensen7, Charlotte Höybye1, 4, 8, Aleksandra Debowska9, Bjørn Gunnar Nedrebø1, 10, Anne Lise Dahle10, Siri Carlsen11, Aneta Tomkowicz12, Synnøve Holte13, Stina Therese Sollid14, Ingrid Nermoen15, Kaja Grønning15, Per Dahlqvist16, Guri Grimnes17, 18, , Jakob Skov14, Trine Finnes19, Susanna Valland19, Jeanette Wahlberg20, Katerina Simunkova11, Olle Kämpe2, 4, 21, Eystein Sverre Husebye1, 2, 5, 21, Sophie Bensing2, 4, 8 & Marianne Øksnes1, 2, 5, 21
1University of Bergen, Department of Clinical Science, Bergen, Norway; 2University of Bergen, K.G. Jebsen center for Autoimmune Disorders, Bergen, Norway; 3Örebro University Hospital, Department of Medicine, Örebro, Sweden; 4Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden; 5Haukeland University Hospital, Department of Medicine, Bergen, Norway; 6Endocrinology in Charlottenburg, Berlin, Germany; 7Oslo University Hospital, Department of Endocrinology, Oslo, Norway; 8Karolinska University Hospital, Department of Endocrinology, Metabolism and Diabetes, Stockholm, Sweden; 9Vestfold Hospital Trust, Department of Medicine, Tønsberg, Norway; 10Haugesund Hospital, Department of Internal Medicine, , Haugesund, Norway; 11Stavanger University Hospital, Department of Endocrinology, Stavanger, Norway; 12Sørlandet Hospital, Department of Medicine, Kristiansand, Norway; 13Sørlandet Hospital, Department of Medicine, Arendal, Norway; 14Drammen Hospital, Department of Medicine, Drammen, Norway; 15Akershus University Hospital, Department of Endocrinology, Lørenskog, Norway; 16Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden; 17University Hospital of North Norway, Division of Internal Medicine, Tromsø, Norway; 18UiT the Arctic University of Norway, , Department of Clinical Medicine, Tromsø, Norway; 19Innlandet Hospital Trust, Section of Endocrinology, Hamar, Norway; 20Linköping University, Department of Endocrinology and Department of Health, Medicine and Caring Sciences, , Linköping, Sweden; 21Karolinska University Hospital, Department of Medicine (Solna), Stockholm, Sweden
Background
Residual adrenocortical function (RAF) is present in one third of patients with autoimmune Addison’s disease (AAD), yet its clinical significance remains unknown.
Objective
To investigate if biomarker profiles of cardiovascular disease and inflammation are different in patients with AAD and RAF compared to patients without RAF and healthy controls.
Material and methods
24 patients with autoimmune Addison’s disease and 24 healthy controls matched for age, sex, and body mass index were included. Blood was sampled at 8 h. Before sampling, patients with AAD had abstained from any GC replacement for at least 18 hours. Nine of the 24 AAD patients had RAF, defined as detectable levels of serum cortisol and 11-deoxycortisol in a medication fasting morning blood sample (1). Blood samples were analyzed for 176 unique plasma proteins (biomarkers) using two 92-plex Olink Proteomics panels: Cardiovascular disease II (CVD II) and Inflammation.
Results
Biomarker expression significantly differed for 13 of the 92 biomarkers of CVD and 11 of the 88 biomarkers of Inflammation (two of which were included in both panels) between AAD patients with RAF, without RAF, and healthy controls (Kruskal-Wallis test, P ≤ 0.010). The 13 CVD biomarkers were ADM, CEACAM8, FGF-23, GAL-9, HAOX1, IL-6, LOX-1, RAGE, SRC, STK4, THBS2, TNFRSF10A, and XCL1. The 11 inflammation biomarkers were CCL-19, CXCL-10, CXCL9, FGF-23, IL-10, IL-6, LAP TGF-beta1, MCP-1, ST1A1, TNFRSF9, and TRAIL. For nine of the 13 CVD biomarkers and ten of the 11 Inflammation biomarkers, the difference in biomarker expression was only significant between patients without RAF and healthy controls, in which patients with RAF had expression levels in between the two other groups. All but three of the 13 CVD biomarkers (LOX-1, SRC, STK4) and two of 11 inflammation biomarkers (LAP TGF-beta1, ST1A1) had higher expression in patients with and/or without RAF compared to healthy controls. For two of the 13 CVD biomarkers (STK4 and RAGE), expression levels significantly correlated with medication fasting morning cortisol (STK4 r = 0.477, P < 0.025 and RAGE r = 0.495, P < 0.019) in patients with AAD. No significant correlations were found between the 11 inflammation biomarkers and cortisol levels.
Conclusion
In AAD, patients with RAF have distinct biomarker profiles of cardiovascular disease and inflammation compared to patients without RAF as well as healthy controls. The findings suggest that RAF in AAD may be clinically significant and warrants further investigation.
Reference
1. Sævik ÅB et al. Residual Corticosteroid Production in Autoimmune Addison Disease. J Clin Endocrinol Metab. 2020;105(7).
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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