Copeptin Levels in Clinically Silent Multiple Sclerosis

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.