İrem İlgezdi1, Ufuk Şener2, Levent Öcek2, Şükran Köse3, Alp Sarıteke2, Figen Tokuçoğlu4, Yaşar Zorlu2

1Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Istanbul, Turkey
2University of Health Sciences Turkey, Izmir Tepecik Training and Research Hospital, Clinic of Neurology, Izmir, Turkey
3University of Health Sciences Turkey, Izmir Tepecik Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiyology, Izmir, Turkey
4Balikesir University Faculty of Medicine, Department of Neurology, Balikesir, Turkey

Keywords: Hypothalamic pituitary adrenal axis, multiple sclerosis, copeptin


Objective: Hypothalamic-pituitary-adrenal (HPA) axis dysfunction is thought to be found in patients with multiple sclerosis (MS). Copeptin is a serum protein that is indicated as an indirect marker of HPA axis. The aim of this study was to evaluate the relationship between HPA axis and clinically silent MS (CSMS) by evaluating copeptin levels.

Materials and Methods: Sixty patients with CSMS which was defined as relapsing-remitting MS without attack and progression, and 60 healthy individuals were included in the study from September 2016 to September 2017. All patients were in the remission period. HPA axis dysfunction was examined by measuring serum copeptin levels in all individuals. Copeptin level was compared with clinical parameters in patients with MS.

Results: A total of 120 individuals were composed of 60 patients with CSMS and 60 healthy controls. The average ages of the patients and the control group were 37.1±8 (20-52) and 35.1±8.9 (18-54), respectively. The copeptin level was significantly lower in patients compared to the control group (p<0.001). In both groups, gender played no differential role in copeptin levels (p<0.05). No significant correlation was determined between copeptin levels, age (r=0.121, p=0.188), last Expanded Disability Status Scale score (r=-0.035, p=0.790) and disease duration (r=0.032, p=0.810).

Conclusion: These results indicate that HPA axis may also be hypoactive in remission period in patients with CSMS. According to our findings, we consider that copeptin levels can be used as a prognostic marker in patients with clinically inactive MS in the future.

Ethics Committee Approval

University of Health Sciences Turkey, Izmir Tepecik Training and Research Hospital Ethics Committee approved the study (approval no: 29/2016).

Peer Review

Externally and internally peer-reviewed.

Author Contributions

Concept: İ.İ., U.Ş., Ş.K., Y.Z., Design: İ.İ., U.Ş., Ş.K., Y.Z., L.Ö., Data Collection or Processing: İ.İ., L.Ö., U.Ş., A.S., F.T., Analysis or Interpretation: L.Ö., İ.İ., Literature Search: L.Ö., İ.İ., U.Ş., F.T., Y.Z., Writing: İ.İ., L.Ö., U.Ş.

Conflict of Interest

No conflict of interest was declared by the authors.

Financial Disclosure

The authors declared that this study received no financial support.