Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 17;189(4):438-447.
doi: 10.1093/ejendo/lvad136.

Altered biomarkers for cardiovascular disease and inflammation in autoimmune Addison's disease - a cross-sectional study

Åse Bjorvatn Sævik  1   2 , Grethe Ueland  1   2   3 , Anna-Karin Åkerman  4   5 , Paal Methlie  1   2   3 , Marcus Quinkler  6 , Anders Palmstrøm Jørgensen  7 , Charlotte Höybye  4   8 , Aleksandra W J Debowska  9 , Bjørn Gunnar Nedrebø  10 , Anne Lise Dahle  10 , Siri Carlsen  11 , Aneta Tomkowicz  12 , Stina Therese Sollid  13 , Ingrid Nermoen  14 , Kaja Grønning  14 , Per Dahlqvist  15 , Guri Grimnes  16   17 , Jakob Skov  4 , Trine Finnes  18 , Susanna F Valland  18 , Jeanette Wahlberg  19   20 , Synnøve Emblem Holte  21 , Olle Kämpe  2   8   22 , Sophie Bensing  4   8 , Eystein Sverre Husebye  1   2   3   22 , Marianne Øksnes  1   2   3   22
Affiliations
Free article

Altered biomarkers for cardiovascular disease and inflammation in autoimmune Addison's disease - a cross-sectional study

Åse Bjorvatn Sævik et al. Eur J Endocrinol. .
Free article

Abstract

Objective: Increased prevalence of cardiovascular disease has been reported in autoimmune Addison's disease (AAD), but pathomechanisms are poorly understood.

Design: Cross-sectional study.

Methods: We compared serum levels of 177 cardiovascular and inflammatory biomarkers in 43 patients with AAD at >18-h glucocorticoid withdrawal and 43 matched controls, overall and stratified for sex. Biomarker levels were correlated with the frequency of adrenal crises and quality of life (QoL) by AddiQoL-30. Finally, we investigated changes in biomarker levels following 250 µg tetracosactide injection in patients without residual adrenocortical function (RAF) to explore glucocorticoid-independent effects of high ACTH.

Results: Nineteen biomarkers significantly differed between patients with AAD and controls; all but 1 (ST1A1) were higher in AAD. Eight biomarkers were significantly higher in female patients compared with controls (IL6, MCP1, GAL9, SPON2, DR4, RAGE, TNFRSF9, and PGF), but none differed between male patients and controls. Levels of RAGE correlated with the frequency of adrenal crises (r = 0.415, P = .006) and AddiQoL-30 scores (r = -0.347, P = .028) but not after correction for multiple testing. PDL2 and leptin significantly declined 60 min after injection of ACTH in AAD without RAF (-0.15 normalized protein expression [NPX], P = .0001, and -0.25 NPX, P = .0003, respectively).

Conclusions: We show that cardiovascular and inflammatory biomarkers are altered in AAD compared with controls, particularly in women. RAGE might be a marker of disease severity in AAD, associated with more adrenal crises and reduced QoL. High ACTH reduced PDL2 and leptin levels in a glucocorticoid-independent manner but the overall effect on biomarker profiles was small.

Keywords: autoimmunity; biomarkers; cardiovascular disease; primary adrenal insufficiency; proteomics.

PubMed Disclaimer