Visceral Fat and Novel Biomarkers of Cardiovascular Disease in Patients With Addison’s Disease: A Case-Control Study
The Journal of Clinical Endocrinology & Metabolism, 2017
Bergthorsdottir R., Ragnarsson O., Skrtic S., Glad C., Nilsson S., Ross I., Leonsson-Zachrisson M., Johannsson G.
| Disease area | Application area | Sample type | Products |
|---|---|---|---|
Endocrinology | Pathophysiology |
Abstract
Context
Patients with Addison’s disease (AD) have increased cardiovascular mortality.
Objective
To study visceral fat and conventional and exploratory cardiovascular risk factors in patients with AD.
Design
A cross-sectional, single-center, case-control study.
Subjects
Patients (n = 76; n = 51 women) with AD and 76 healthy control subjects were matched for sex, age, body mass index (BMI), and smoking habits.
Main outcome measures
The primary outcome variable was visceral abdominal adipose tissue (VAT) measured using computed tomography. Secondary outcome variables were prevalence of metabolic syndrome (MetS) and 92 biomarkers of cardiovascular disease.
Results
The mean ± standard deviation age of all subjects was 53 ± 14 years; mean BMI, 25 ± 4 kg/m2; and mean duration of AD, 17 ± 12 years. The median (range) daily hydrocortisone dose was 30 mg (10 to 50 mg). Median (interquartile range) 24-hour urinary free cortisol excretion was increased in patients vs controls [359 nmol (193 to 601 nmol) vs 175 nmol (140 to 244 nmol); P < 0.001]. VAT did not differ between groups. After correction for multiple testing, 17 of the 92 studied biomarkers differed significantly between patients and control subjects. Inflammatory, proinflammatory, and proatherogenic risk biomarkers were increased in patients [fold change (FC), >1] and vasodilatory protective marker was decreased (FC, <1). Twenty-six patients (34%) vs 12 control subjects (16%) fulfilled the criteria for MetS (P = 0.01).ConclusionDespite higher cortisol exposure, VAT was not increased in patients with AD. The prevalence of MetS was increased and several biomarkers of cardiovascular disease were adversely affected in patients with AD.