MicroRNA Expression Profiles: A New Approach to Distinguish Cushing's Syndrome from Primary Hypertension

Abstract

Abstract Context Cushing’s syndrome (CS) is a rare disease characterized with excessive cortisol production and it is associated with high morbidity and mortality. Diagnosis of CS remains an area of concern. Objective Circulating microRNAs are minimally invasive diagnostic biomarkers. Our aim was to characterize and evaluate the circulating microRNAs profiles in the process of distinguishing of patients with primary hypertension (PHT) and patients with CS. Results 172 circulating microRNAs were differentially expressed in CS compared to PHT group. 69 microRNAs (26 upregulated, 43 downregulated) showed a significant differential expression in CS. The most pronounced significant differential expression was observed in miR-486-5p. Receiver Operating Characteristic (ROC) analysis for the validation of the applicability of 6 microRNAs identified as the most differentially expressed (miR-486-5p, miR-629-5p, miR-451a, miR-376c-3p, miR-376a-3p, and miR-27b-3p) showed an average area under the curve (AUC) ≥0.7. comparative analysis across genders showed gender-related distinctions in microRNA expression profiles between CS and PHT patients. Particularly in females, significant differential microRNA expression was observed. While males did not show any significant microRNA expressions. Certain microRNAs did not exhibit significant differential expression between CS and PHT, however, they displayed a notable effect on the pathophysiology of hypertension (HTN) by showing significant values when comparing hypertensive individuals to normotensive. Outcome In conclusion, our study identified miR-486-5p as a possible biomarker with AUC= 0.9 to distinguish CS from PHT. This finding needs further confirmation through the validation in a prospective study cohort.