ECEESPE2025 Poster Presentations Adrenal and Cardiovascular Endocrinology (169 abstracts)
Circulating GDF-15 is elevated in adrenal cushing’s syndrome but not in cushing’s disease
Ilaria Bonaventura 1,2 , Elisabeth Nowak 1 , Marceli Chojnacki 1 , Júnia Schweizer 1 , Isabel Stüfchen 1 , Friederike Völter 1 , Paul Schwarzlmüller 1 , Isabel Weigand 1 , Alexandra Triebig 1 , Tanja Maier 1 , Isabella Kinker 1 , Stephanie Zopp 1 , Andrea Isidori 2 , Felix Beuschlein 1,3,4 , Matthias Kroiss 1 & Martin Reincke 1
1LMU University Hospital, LMU Munich, Department of Medicine IV, Munich, Germany; 2Sapienza University of Rome, Experimental Medecine, Rome, Italy; 3University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland; 4The LOOP Zurich – Medical Research Center, Zurich, Switzerland
JOINT1468
Context: Growth/differentiation factor 15 (GDF-15) is a cytokine involved in immunosuppression and anorexia and secreted primarily in response to mitochondrial dysfunction. Recent studies suggest its potential implication in the hypothalamic–pituitary–adrenal axis.
Objective: To investigate the potential role of GDF-15 in adrenal steroid dysregulation in Cushing’s syndrome (CS).
Design: Case–control study.
Methods: Circulating GDF-15 concentrations were assessed in plasma from 25 patients with confirmed overt CS (16 pituitary, 9 adrenal) and 30 age-, BMI-, and sex-matched patients in whom CS was ruled out.
Results: Plasma GDF-15 was significantly higher in CS compared to the control group (644 pg/ml [487.3–797.6] vs 520.9 pg/ml [353.2–665.9], P=0.033). GDF-15 plasma concentrations were positively correlated with age (r=0.423, P<0.001), HbA1c (r=0.329, P=0.014), serum cortisol following dexamethasone suppression test (DST) (r=0.484, P<0.001), and late-night salivary cortisol (r=0.334, P=0.014), while negative correlations were observed with ACTH (r=−0.310, P=0.023) and DHEA-S (r=−0.538, P<0.001). In multivariate linear regression, age (B=8.955, P=0.045), DST (B=7.980, P=0.050) and DHEA-S (B=−58.215, P=0.035) emerged as independent predictors of GDF-15 concentration (R2=0.311, P=0.002). Plasma GDF-15 was significantly higher in adrenal CS compared to pituitary CS (797.6 pg/ml [723.0–1212.2] vs 523.2 pg/ml [441.3–668.1], P=0.002). Binomial logistic regression identified GDF-15 as an independent predictor of adrenal CS diagnosis (OR=1.005, P=0.040). ROC analysis revealed that the diagnostic accuracy of GDF-15 approached that of DHEA-S and ACTH.
Conclusion: This study identified elevated GDF-15 concentrations in patients with adrenal CS. This observation may reflect cellular stress in response to adrenal steroid dysregulation and could be an additional contributor to immunosuppression in CS.
Volume 110
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Endocrine Abstracts
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