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Exp Clin Endocrinol Diabetes 2014; 122(04): 254-258
DOI: 10.1055/s-0034-1370920
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Relationship between Autoantibody to the Angiotensin II-1 Receptor and Cardiovascular Manifestations of Graves’ Disease

J. Xu
1   Wuhan Clinical Medicine College, Southern Medical University, Wuhan, China
2   Department of Endocrinology and metabolism, Wuhan General Hospital of Guangzhou Command, Wuhan, China
,
L. Zhao
2   Department of Endocrinology and metabolism, Wuhan General Hospital of Guangzhou Command, Wuhan, China
,
G. Xiang
2   Department of Endocrinology and metabolism, Wuhan General Hospital of Guangzhou Command, Wuhan, China
,
C. Xu
2   Department of Endocrinology and metabolism, Wuhan General Hospital of Guangzhou Command, Wuhan, China
› Author Affiliations
Further Information

Publication History

received 29 October 2013
first decision 26 December 2013

accepted 11 February 2014

Publication Date:
25 April 2014 (online)

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Abstract

Objective:

To investigate the role of autoantibody against angiotensin II-1 receptor (AT1-AA) in patients with cardiovascular manifestations of Graves’ disease (GD).

Methods:

The epitope of the second extracellular loop of AT1 receptor (165–191) was synthesized and used as antigens to screen the autoantibody by enzyme linked immunosorbent assay (ELISA). The patients with GD were divided into the patients with cardiovascular manifestations associated to GD (Group A, n=58) and the patients with GD not complicated by heart disease (Group B, n=60). 40 healthy subjects were included in the study (Group C, n=40). Echocardiography was performed and the differences of echocardiography parameters were compared between AT1-AA positive and negative groups in group A. Factors related to left heart enlargement were analyzed by multiple logistic regression.

Results:

(1) The frequency of AT1-AA in Group A (52.2%, 32/58) were significantly higher than those in Group B (16.7%, 10/60) and Group C (12.5%, 5/40) (all p<0.001). (2) There were no differences in the level of TGAb, TPOAb and TRAb between AT1-AA positive and negative groups in patients with GD (all p>0.05). (3) In patients with cardiovascular manifestations of GD, the ratios between left atrial and ventricular enlargement (LAE and LVE) were significantly higher in the AT1-AA positive group than in the AT1-AA negative group (68.8% vs. 26.9%, 62.5% vs. 23.1%, all p<0.01); the frequency of atrial fibrillation differed significantly between these 2 groups (53.1% vs. 19.2%, p<0.01). (4) Regression analysis demonstrated that the positive AT1-AA and course of GD were significantly correlated to the presence of LAE and LVE.

Conclusions:

AT1-AA plays an important role in the pathogenesis of cardiovascular manifestations associated to GD. Especially, AT1-AA is involved in left cardiac dilatation of GD complicated by heart disease, which represents a cardio­vascular risk factor for GD patients.

Key words

angiotensin II-1 - receptor - autoantibody - cardiovascular manifestations - Graves’ disease
 

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