Abstract:
:Background and objectives Glucocorticoids are used to manage adrenal insufficiency (AI). We describe treatments used in the United Kingdom and real-world clinical outcomes for each treatment. Methods We used 2010-2016 primary care data from The Health Improvement Network (THIN). Descriptive analyses were conducted, and differences in variables between patients prescribed immediate-release hydrocortisone (IR HC), prednisolone or modified-release hydrocortisone (MR HC) were assessed using Fisher's exact test. Results Overall, 2648 patients were included: 1912 on IR HC (72%), 691 on prednisolone (26%) and 45 (2%) on MR HC. A total of 1174 (44.3%) had primary and 1150 (43.4%) had secondary AI. Patients on prednisolone were older (P < 0.001) and had a greater history of smoking (292/691, P < 0.001) and CVD (275/691, P < 0.001). Patients on MR HC had more PCOS (3/45, P = 0.001) and diabetes (27/45, P = 0.004). The number of GP visits/patient/year was 6.50 in IR HC, 9.54 in prednisolone and 9.11 in MR HC cohorts. The mean number of A&E visits and inpatient and outpatient hospital admissions ranged from 0.42 to 0.93 visits/patient/year. The mean number of adrenal crises/patient/year was between 0.02 and 0.03 for all cohorts. Conclusion IR HC is most commonly used for the management of AI in the United Kingdom, followed by prednisolone. Few patients receive MR HC. The prednisolone and MR HC cohorts displayed a greater prevalence of vascular risk factors compared with IR HC. The occurrence of AC and primary and secondary resource use were similar between treatment cohorts, and they indicate significant resource utilisation. Improved treatment and management of patients with AI is needed.
journal_name
Endocr Connectjournal_title
Endocrine connectionsauthors
Iqbal K,Halsby K,Murray RD,Carroll PV,Petermann Rdoi
10.1530/EC-18-0418subject
Has Abstractpub_date
2019-01-01 00:00:00pages
20-31issue
1issn
2049-3614pii
EC-18-0418journal_volume
8pub_type
杂志文章abstract::The genetic aetiology of congenital hypopituitarism (CH) is not entirely elucidated. FGFR1 and PROKR2 loss-of-function mutations are classically involved in hypogonadotrophic hypogonadism (HH), however, due to the clinical and genetic overlap of HH and CH; these genes may also be involved in the pathogenesis of CH. Us...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-15-0015
更新日期:2015-06-01 00:00:00
abstract::Tumor cells require large amounts of energy to sustain growth. Through the mediated transport of glucose transporters, the uptake and utilization of glucose by tumor cells are significantly enhanced in the hypoxic microenvironment. Pituitary adenomas are benign tumors with high-energy metabolisms. We aimed to investig...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-18-0444
更新日期:2018-12-01 00:00:00
abstract::Sex development is a process under genetic control directing both the bi-potential gonads to become either a testis or an ovary, and the consequent differentiation of internal ducts and external genitalia. This complex series of events can be altered by a large number of genetic and non-genetic factors. Disorders of s...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-14-0085
更新日期:2014-12-01 00:00:00
abstract::Classic galactosemia is a rare inborn error of galactose metabolism with a birth prevalence of about 1/30 000-60 000. Long-term complications occurring despite dietary treatment consist of premature ovarian insufficiency (POI) and neurodevelopmental impairments. We performed with the French Reference Centers for Rare ...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-21-0013
更新日期:2021-01-01 00:00:00
abstract::The vasoactive intestinal peptide receptor 2 (VPAC2) is widely distributed throughout the body and is also overexpressed in a variety of human neoplastic tissues. However, little is known about its precise tissue distribution, regulation and function, which is in part be due to the lack of specific monoclonal anti-VPA...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-14-0051
更新日期:2015-03-01 00:00:00
abstract:CONTEXT:Women with polycystic ovary syndrome (PCOS) have an increased risk of cardiovascular disease (CVD), and biomarkers can be used to detect early subclinical CVD. Midregional-pro-adrenomedullin (MR-proADM), midregional-pro-atrial natriuretic peptide (MR-proANP) and copeptin are all associated with CVD and part of ...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-17-0327
更新日期:2018-01-01 00:00:00
abstract:AIMS:Gestational diabetes mellitus (GDM)-induced macrosomia is predominantly characterized by fat accumulation, which is closely related to adipocyte differentiation. An unknown long noncoding RNA RP11-290L1.3, referred to as RP11, was identified to be dramatically upregulated in the umbilical cord blood of women with ...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-20-0584
更新日期:2021-01-01 00:00:00
abstract::Hypothyroidism is associated with increased risk of atherosclerosis. We assessed carotid intima-media thickness (CIMT), as a marker of atherosclerosis, and endothelial function in patients with hypothyroidism. We included 70 female patients with hypothyroidism in the study, 40 patients with overt and 30 patients with ...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-18-0194
更新日期:2018-10-01 00:00:00
abstract:Objective:The remarkable success of iodine deficiency disorders (IDD) elimination in China has been achieved through a mandatory universal salt iodization (USI) program. The study aims to estimate the relationship between urinary iodine concentration (UIC) and iodine content in edible salt to assess the current iodine ...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-19-0568
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:The European Reference Network on Rare Endocrine Conditions (Endo-ERN), operational since 2017, consists of 71 health care providers (HCPs) in 19 EU member states. Our objective was to assess education and knowledge on rare endocrine conditions. DESIGN AND METHODS:A survey was developed and sent through the ...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-20-0480
更新日期:2020-12-01 00:00:00
abstract:AIMS:The cumulative effect of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) on postpartum cardio-metabolic diseases is equivocal. We aimed to assess the associations of GDM and HDP's individual and synergic contribution to risks of postpartum cardio-metabolic diseases (metabolic synd...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-17-0359
更新日期:2018-03-01 00:00:00
abstract::Steroid hormones play clinically important and specific regulatory roles in the development, growth, metabolism, reproduction and brain function in human. The type 1 and 2 11-beta hydroxysteroid dehydrogenase enzymes (11β-HSD1 and 2) have key roles in the pre-receptor modification of glucocorticoids allowing aldostero...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-17-0119
更新日期:2017-10-01 00:00:00
abstract::Promotion of brown adipose tissue (BAT) activity or browning of white adipose tissue has shown great potential as anti-obesity strategy in numerous preclinical models. The discovery of active BAT in humans and the recent advances in the understanding of human BAT biology and function have significantly propelled this ...
journal_title:Endocrine connections
pub_type: 杂志文章,评审
doi:10.1530/EC-17-0037
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The value of postoperative radiotherapy in the treatment of medullary thyroid carcinoma (MTC) has not been unequivocally demonstrated. Therefore our study aimed to answer the question of whether adjuvant radiotherapy showed any impact on the risk of local recurrence and whether there were any differences in ...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-19-0387
更新日期:2019-11-01 00:00:00
abstract::Thyroid hormones stimulate bone turnover in adults by increasing osteoclastic bone resorption. TSH suppressive therapy is usually applied in patients with differentiated thyroid cancer (DTC) to improve the disease outcome. Over the last decades several authors have closely monitored the potential harm suffered by the ...
journal_title:Endocrine connections
pub_type: 杂志文章,评审
doi:10.1530/EC-20-0167
更新日期:2020-07-01 00:00:00
abstract::The renin-angiotensin system (RAS), mainly associated with the regulation of blood pressure, has been recently investigated in female reproductive organs and the developing foetus. Angiotensin II (Ang II) influences oviductal gamete movements and foetal development, but there is no information about RAS in the early e...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-12-0013
更新日期:2012-06-21 00:00:00
abstract::Failure to suppress testosterone below 0.7 nM in castrated prostate cancer patients is associated with poor clinical outcomes. Testosterone levels in castrated patients are therefore routinely measured. Although mass spectrometry is the gold standard used to measure testosterone, most hospitals use an immunoassay meth...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-18-0476
更新日期:2019-02-01 00:00:00
abstract:Background:A high level of free triiodothyronine (FT3) within the reference range may be a potential metabolic risk marker. However, the relationship between different fat depots and FT3 has remained unclear. Objective:We aimed to explore the relationships between segmental fat distribution and FT3 in euthyroid middle...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-19-0394
更新日期:2019-10-01 00:00:00
abstract::Hypercalcemic crisis is a severe but rare complication of primary hyperparathyroidism (PHPT), and data on denosumab treatment of patients with this disease is still very limited. The aim of this paper is to investigate the hypocalcemic effect of denosumab in PHPT patients with severe hypercalcemia when surgery should ...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-20-0380
更新日期:2020-10-01 00:00:00
abstract::Insufficient insulin release plays a crucial role in the development of unhealthy status in patients with obesity; the present study aimed to classify these patients by the indices for insulin resistance and insulin release. After the indices from OGTT were assessed to achieve high differentiability and low redundancy...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-19-0476
更新日期:2020-02-01 00:00:00
abstract::Growth hormone (GH) is used to treat short stature and growth failure associated with growth disorders. Birth size and GH status variably modulate response to GH therapy. The aim of this study was to determine the effect of birth size on response to GH therapy, and to determine the impact of GH status in patients born...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-18-0286
更新日期:2018-08-23 00:00:00
abstract:OBJECTIVE:Little is known about how women with isolated GnRH deficiency cope with their condition. This study aimed to examine the health and informational needs of women with congenital hypogonadotropic hypogonadism (CHH) and evaluate if their experiences differ from women with more common forms of infertility. DESIG...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-17-0095
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Insulin-like growth factors are implicated in the development of diabetic nephropathy. IGF-binding protein 2 (IGFBP2) and IGF2 are expressed in the kidney, but their associations with diabetic nephropathy are unclear. We therefore tested the hypothesis that circulating levels of IGF2 and IGFBP2 predict longit...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-12-0053
更新日期:2012-10-24 00:00:00
abstract::The current investigation examined the association between the aging-related biomarkers dehydroepiandrosterone (DHEA) and telomere length (TL) in community-recruited African-American youth. The examination of DHEA included stress reactive, basal and diurnal sampling, in order to elucidate the underlying physiological ...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-16-0007
更新日期:2016-05-01 00:00:00
abstract::Primary hyperparathyroidism (PHPT) is a common endocrinopathy, frequently caused by a parathyroid adenoma, rarely by a parathyroid carcinoma that lacks effective oncological treatment. As the majority of cases are present in postmenopausal women, oestrogen signalling has been implicated in the tumourigenesis. Oestroge...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-14-0109
更新日期:2015-03-01 00:00:00
abstract::Macroprolactinomas are the most common functional pituitary tumours. Hypotheses proposed to explain predominance of large tumours in males are: i) diagnostic delay, as hyperprolactinaemia remains under recognised in males and ii) gender-specific difference in tumour proliferation indices. Our study objectives are to c...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-15-0105
更新日期:2016-01-01 00:00:00
abstract::Phaeochromocytomas and paragangliomas (PPGLs) are tumours of the adrenal medulla and extra-adrenal sympathetic nervous system which often secrete catecholamines. Variants of the SDHX (SDHA, -AF2, -B, -C, -D) genes are a frequent cause of familial PPGLs. In this study from a single tertiary centre, we aimed to characte...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-20-0279
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Primary aldosteronism (PA) is associated with increased cardiovascular morbidity, presumably due to left ventricular (LV) hypertrophy and fibrosis. However, the degree of fibrosis has not been extensively studied. Cardiac magnetic resonance imaging (CMR) contrast enhancement and novel sensitive T1 mapping to...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-18-0039
更新日期:2018-03-01 00:00:00
abstract::This study aims to summarize and analyze the clinical manifestations, genetic characteristics, treatment modalities and long-term prognosis of congenital hyperinsulinemia (CHI) in Chinese children. Sixty children with CHI, who were treated at Beijing Children's Hospital from January 2014 to August 2017, and their fami...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-18-0240
更新日期:2018-11-12 00:00:00
abstract:Objective:First-line chemotherapy in metastatic neuroendocrine carcinomas (NECs) is based on etoposide and platinum. However, there is no standard concerning second-line treatment. The objective of this study was to evaluate efficacy and tolerance of dacarbazine or temozolomide in metastatic digestive NEC as post first...
journal_title:Endocrine connections
pub_type: 杂志文章
doi:10.1530/EC-20-0192
更新日期:2020-06-01 00:00:00