The Impact of Glucocorticoid Co-Secretion in Primary Aldosteronism on Thyroid Autoantibody Titers During the Course of Disease.
Journal
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme
ISSN: 1439-4286
Titre abrégé: Horm Metab Res
Pays: Germany
ID NLM: 0177722
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
pubmed:
14
5
2020
medline:
7
4
2021
entrez:
14
5
2020
Statut:
ppublish
Résumé
Excess aldosterone is associated with the increased risk of cardio-/cerebrovascular events as well as metabolic comorbidities not only due to its hypertensive effect but also due to its proinflammatory action. Autonomous cortisol secretion (ACS) in the setting of primary aldosteronism (PA) is known to worsen cardiovascular outcome and potentially exhibit immunosuppressive effects. The aim of this study was to determine the impact of ACS status in patients with PA on kinetics of thyroid autoantibodies (anti-TPO, anti-TG) pre and post therapy initiation. Ninety-seven PA patients (43 unilateral, 54 with bilateral PA) from the database of the German Conn's Registry were included. Anti-TPO and anti-TG levels were measured pre and 6-12 months post therapeutic intervention. Patients were assessed for ACS according to their 24- hour urinary cortisol excretion, late night salivary cortisol and low-dose dexamethasone suppression test. Abnormal test results in line with ACS were identified in 74.2% of patients with PA. Following adrenalectomy, significant increases in anti-TPO levels were observed in patients with at least one abnormal test (p = 0.049), adrenalectomized patients with at least two pathological ACS tests (p = 0.015) and adrenalectomized patients with pathologic dexamethasone suppression tests (p = 0.018). No antibody increases were observed in unilateral PA patients without ACS and in patients with bilateral PA receiving mineralocorticoid antagonist therapy (MRA). Our data are in line with an immunosuppressive effect of mild glucocorticoid excess in PA on thyroid autoantibody titers. This effect is uncovered by adrenalectomy, but not by MRA treatment.
Identifiants
pubmed: 32403151
doi: 10.1055/a-1164-1944
pmc: PMC7746512
doi:
Substances chimiques
Autoantibodies
0
Glucocorticoids
0
Aldosterone
4964P6T9RB
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
404-411Informations de copyright
© Georg Thieme Verlag KG Stuttgart · New York.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest.
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