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Visceral Fat and Novel Biomarkers of Cardiovascular Disease in Patients With Addison's Disease: A Case-Control Study

Artikel i vetenskaplig tidskrift
Författare Ragnhildur Bergthorsdottir
Oskar Ragnarsson
Stanko Skrtic
Camilla A M Glad
Staffan Nilsson
I. L. Ross
M. Leonsson-Zachrisson
Gudmundur Johannsson
Publicerad i Journal of Clinical Endocrinology & Metabolism
Volym 102
Nummer/häfte 11
Sidor 4264-4272
ISSN 0021-972X
Publiceringsår 2017
Publicerad vid Institutionen för biomedicin, avdelningen för medicinsk genetik och klinisk genetik
Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 4264-4272
Språk en
Länkar dx.doi.org/10.1210/jc.2017-01324
Ämnesord conventional glucocorticoid replacement, subjective health-status, metabolic syndrome, adrenal insufficiency, cushings-syndrome, mortality, risk, coronary, death, homeostasis, Endocrinology & Metabolism
Ämneskategorier Endokrinologi

Sammanfattning

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. 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 6 standard deviation age of all subjects was 53 6 14 years; mean BMI, 25 6 4 kg/ m2; and mean duration of AD, 17 6 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). Conclusion: Despite 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.

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