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Metabolic and cardiovascular profile in patients with Addison's disease under conventional glucocorticoid replacement.

Abstract：

OBJECTIVE:Although two studies have shown that Addison's disease (AD) is still a potentially lethal condition for cardiovascular, malignant, and infectious diseases, a recent retrospective study showed a normal overall mortality rate. Differently from secondary hypoadrenalism, scanty data exist on the role of conventional glucocorticoid replacement on metabolic and cardiovascular outcome in AD. SUBJECTS AND METHODS:In 38 AD under conventional glucocorticoid replacement (hydrocortisone 30 mg/day or cortisone 37.5 mg/day) ACTH, plasma renin activity (PRA), DHEAS, fasting glucose and insulin, 2-h glucose after oral glucose tolerance test, serum lipids, 24-h blood pressure and intima-media thickness (IMT) were evaluated and compared with 38 age-, sex- and body mass index (BMI)-matched controls (CS). RESULTS:AD had ACTH and PRA higher and DHEAS lower (p<0.0005) than CS. Mean waist was higher (p<0.05) in AD than in CS. Although no differences were found for mean gluco-lipids levels, a higher percentage of AD compared to CS were IGT (8 vs 0%), hypercholesterolemic (18 vs 8%), and hypertriglyceridemic (18 vs 8%); none of the AD and CS showed either HDL<40 mg/dl or LDL>190 mg/dl. At the multiple regression analysis, in both AD and CS, BMI was the best predictor of 2-h glucose and age of total and LDL cholesterol; in AD, no significant correlation was found between the above mentioned metabolic parameters and either hormone levels or disease duration. In both AD and CS 24-h blood pressure and IMT were normal. CONCLUSIONS:Our study shows a higher prevalence of central adiposity, impaired glucose tolerance and dyslipidemia in AD patients.

journal_name

J Endocrinol Invest

journal_title

Journal of endocrinological investigation

authors

Giordano R,Marzotti S,Balbo M,Romagnoli S,Marinazzo E,Berardelli R,Migliaretti G,Benso A,Falorni A,Ghigo E,Arvat E

doi

10.1007/BF03345773

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

917-23

issue

11

eissn

0391-4097

issn

1720-8386

pii

6437

journal_volume

32

pub_type

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