Plasma-Metanephrines in Patients with Autoimmune Addison's Disease with and without Residual Adrenocortical FunctionEndocrinology in Charlottenburg, 10627 Berlin, Germany.
Department of Endocrinology, Oslo University Hospital, 0372 Oslo, Norway.
Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden; Department of Endocrinology, Karolinska University Hospital, 171 76 Stockholm, Sweden.
Department of Medicine, Vestfold Hospital Trust, 3103 Tønsberg, Norway.
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; Department of Internal Medicine, Haugesund Hospital, 5528 Haugesund, Norway.
Department of Internal Medicine, Haugesund Hospital, 5528 Haugesund, Norway.
Department of Endocrinology, Stavanger University Hospital, 4068 Stavanger, Norway.
Department of Medicine, Sørlandet Hospital, 4604 Kristiansand, Norway.
Department of Medicine, Drammen Hospital, Vestre Viken Health Trust, 3004 Drammen, Norway.
Department of Endocrinology, Akershus University Hospital, 1478 Lørenskog, Norway.
Department of Endocrinology, Akershus University Hospital, 1478 Lørenskog, Norway.
Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.
Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway; Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT the Arctic University of Norway, 9037 Tromsø, Norway.
Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden.
Section of Endocrinology, Innlandet Hospital Trust, 2381 Hamar, Norway.
Department of Medicine, Sørlandet Hospital, 4838 Arendal, Norway.
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway.
Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden; Department of Endocrinology, Karolinska University Hospital, 171 76 Stockholm, Sweden; Department of Medicine (Solna), Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden.
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, 7804 Bergen, Norway; Department of Medicine, Haukeland University Hospital, 5009 Bergen, Norway; Department of Medicine (Solna), Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden.
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, 7804 Bergen, Norway; Department of Medicine, Haukeland University Hospital, 5009 Bergen, Norway; Department of Medicine (Solna), Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden; Department of Endocrinology, Karolinska University Hospital, 171 76 Stockholm, Sweden.
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2023 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, no 10, article id 3602Article in journal (Refereed) Published
Abstract [en]
PURPOSE: Residual adrenocortical function, RAF, has recently been demonstrated in one-third of patients with autoimmune Addison's disease (AAD). Here, we set out to explore any influence of RAF on the levels of plasma metanephrines and any changes following stimulation with cosyntropin.
METHODS: We included 50 patients with verified RAF and 20 patients without RAF who served as controls upon cosyntropin stimulation testing. The patients had abstained from glucocorticoid and fludrocortisone replacement > 18 and 24 h, respectively, prior to morning blood sampling. The samples were obtained before and 30 and 60 min after cosyntropin stimulation and analyzed for serum cortisol, plasma metanephrine (MN), and normetanephrine (NMN) by liquid-chromatography tandem-mass pectrometry (LC-MS/MS).
RESULTS: Among the 70 patients with AAD, MN was detectable in 33%, 25%, and 26% at baseline, 30 min, and 60 min after cosyntropin stimulation, respectively. Patients with RAF were more likely to have detectable MN at baseline (p = 0.035) and at the time of 60 min (p = 0.048) compared to patients without RAF. There was a positive correlation between detectable MN and the level of cortisol at all time points (p = 0.02, p = 0.04, p < 0.001). No difference was noted for NMN levels, which remained within the normal reference ranges.
CONCLUSION: Even very small amounts of endogenous cortisol production affect MN levels in patients with AAD.
Place, publisher, year, edition, pages
MDPI, 2023. Vol. 12, no 10, article id 3602
Keywords [en]
Addison’s disease, adrenal cortex, adrenal medulla, catecholamines, metanephrines, residual function
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-106094DOI: 10.3390/jcm12103602ISI: 000997093500001PubMedID: 37240708Scopus ID: 2-s2.0-85160573677OAI: oai:DiVA.org:oru-106094DiVA, id: diva2:1760031
Funder
The Research Council of Norway, 288022Novo Nordisk, NNF18OC0034130
Note
Funding agencies:
Internal Medicine Association of Norway
Regional agreement on medical training and clinical research in Stockholm
2023-05-292023-05-292024-01-02Bibliographically approved