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Correction of cortisol overreplacement ameliorates morbidities in patients with hypopituitarism: a pilot study

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Abstract

Context Hyporituitarism in adults is known to be associated with deleterious effects on body composition, lipid profile and quality of life (QoL). This was attributed to GH deficiency. The potential role of glucocorticoid overreplacement had never been investigated. Objective To investigate whether reduction in glucocorticoid replacement dose to more physiological one could ameliorate the “AO-GHD”-attributed symptomatology in patients with hypopituitarism. Design Eleven patients with panhypopituitarism taking 20–30 mg/day of hydrocortisone, but on no GH replacement were switched to 10–15 mg of hydrocortisone daily. Both basally and 6–12 months later, their body mass index, body composition by dual-energy X-ray absorptiometry, lipid profile, and the score of quality of life, QOL-AGHDA were measured. Results Within 6–12 months of lower hydrocortisone dose, subjects lost an average of 7.1 kg of total body fat and 4.1 kg of abdominal fat. No changes were seen in lean body mass, bone mineral content and HOMA-IR. Plasma total cholesterol and triglyceride concentrations decreased significantly (<0.05) and the QoL improved (P = 0.018). Conclusions Our pilot study suggests that decreasing the glucocorticoid replacement dose to ~15 mg/day is beneficial in terms of patients’ body composition, lipid profile and quality of life.

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Authors and Affiliations

  1. Division of Endocrinology, Hospital de Clínicas, Avenida Córdoba 2351, 5° piso, 1120, Ciudad Autónoma de Buenos Aires, Argentina

    Karina Danilowicz, Oscar Domingo Bruno, Marcos Manavela & Reynaldo Manuel Gomez

  2. Diagnóstico Médico SRL, Buenos Aires, Argentina

    Reynaldo Manuel Gomez

  3. Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI, USA

    Ariel Barkan

Authors
  1. Karina Danilowicz
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  2. Oscar Domingo Bruno
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  3. Marcos Manavela
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  4. Reynaldo Manuel Gomez
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  5. Ariel Barkan
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Correspondence to Karina Danilowicz.

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Danilowicz, K., Bruno, O.D., Manavela, M. et al. Correction of cortisol overreplacement ameliorates morbidities in patients with hypopituitarism: a pilot study. Pituitary 11, 279–285 (2008). https://doi.org/10.1007/s11102-008-0126-2

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