Features of endocrine status in adolescents with multiple sclerosis

Introduction. A number of authors have shown changes of hormonal status in adults with multiple sclerosis (MS) compared to healthy volunteers. At the same time, there are few such studies in the pediatric population, conducted on small groups, with ambiguous and contradictory results, which indicates the need for further research in this area. The objective was to determine the endocrine status features in adolescents with MS in comparison with healthy children and adult patients with MS, to assess the relationship between the levels of pituitary hormones, thyroid hormones, cortisol, sex hormones and the activity and severity of MS in adolescents and adults. Methods and materials. The main group consisted of 33 adolescent patients with pediatric MS, the comparison group included 22 adult patients with MS, and the control group comprised 26 healthy adolescents. All participants underwent assessments for the concentrations of prolactin, follicle-stimulating hormone, luteinizing hormone, adrenocorticotropic hormone, thyroid-stimulating hormone, total and free thyroxine, triiodothyronine, cortisol, testosterone, dihydrotestosterone, estradiol, and 17-hydroxyprogesterone. In addition, clinical and MRI characteristics of the disease were evaluated in patients with MS. Results. Prolactin levels in adult and adolescent patients with MS were definitely higher than in a control group. Adolescents with higher cortisol levels at baseline showed a lower severity of motor dysfunction (r=–0.59, p<0.001) and disability as measured by the Expanded Disability Status Scale (EDSS) (r=–0.49, p=0.004). A similar correlation was found for 17-hydroxyprogesterone: adolescents with higher levels of this hormone had less disability according to EDSS (r=–0.36, p=0.04). Adult patients with MS showed a moderate inverse correlation (r=–0.47, p=0.03) between 17-hydroxyprogesterone levels and the severity of cerebellar dysfunction. Adolescents experiencing an MS exacerbation had higher prolactin levels (p=0.04) and lower 17-hydroxyprogesterone levels (p=0.02) compared to those in remission. Conclusion. In adolescents and adults with MS, prolactin levels were significantly higher than in a control group of healthy adolescents. For the first time, a negative correlation between the baseline levels of endogenous steroid hormones and the degree of disability in several functional systems has been demonstrated in adolescents and adults. Changes in prolactin and 17-hydroxyprogesterone levels during MS exacerbation have been observed in adolescents, suggesting that both indicators may be potential targets for developing laboratory markers for disease reactivation.