Substantial changes in inflammatory and cardiovascular biomarkers in patients with autonomous cortisol secretion

Objective To map inflammatory biomarkers in patients with autonomous cortisol secretion (ACS) and overt Cushing syndrome (CS). Method Observational study including serum from prospectively included patients with ACS (n = 63), adrenal CS (n = 2), pituitary CS (n = 8), and healthy subjects (n = 120). Serum samples were analysed for 92 inflammatory biomarkers using proximity extension assay (OLINK). Results Combined, the ACS and CS patients displayed significant differences in levels of 49/92 inflammatory biomarkers (46 increased/3 decreased) compared with healthy controls. No differences in biomarker levels were found between ACS and overt CS, and none of the biomarkers correlated with the degree of hypercortisolism. Postoperative samples were available for 17 patients, median 24 months (range 6-40) after surgery and biochemical curation. There was no significant normalization of the biomarkers postoperatively. Conclusion There was a systemic rise in inflammatory biomarkers in patients with ACS and CS, not correlated to the degree of hypercortisolism. These biomarkers were not normalized following biochemical cure.

Automated summary

This study aimed to map inflammatory biomarkers in patients with autonomous cortisol secretion (ACS) and overt Cushing syndrome (CS). Serum samples from patients with ACS, CS, and healthy subjects were analyzed for 92 inflammatory biomarkers using proximity extension assay (OLINK). The results showed significant differences in levels of 49/92 inflammatory biomarkers between ACS and CS patients and healthy controls. However, there were no differences in biomarker levels between ACS and overt CS, and none of the biomarkers correlated with the degree of hypercortisolism. Postoperative samples showed no significant normalization of the biomarkers. In conclusion, there was a systemic rise in inflammatory biomarkers in patients with ACS and CS, which was not correlated to the degree of hypercortisolism and not normalized following biochemical cure.