Objective: Hypothalamic-pituitary-adrenal (HPA) axis dysfunction is thought to appear 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 clinical silent MS by evaluating copeptin levels.
Materials and Methods: Sixty clinical silent MS(CSMS) patients which is defined as relapsing-remitting multiple
sclerosis (RRMS) patients 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 the serum copeptin levels in all individuals. Copeptin level was compared with clinical parameters in MS
Results: A total of 120 individuals were composed of 60 CSMS patients and 60 healthy control. 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 lower
in patients compared to control group, significantly (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
EDSS 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 CSMS patients.
According to our findings we consider copeptin levels can be used as a prognostic marker in clinically inactive MS
patients in the future.
Keywords: Hypothalamic pituitary adrenal axis, Multiple sclerosis, Copeptin