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

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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.

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Authors and Affiliations

  1. Department of Clinical and Biological Sciences, University of Turin, Orbassano

    R. Giordano

  2. Department of Internal Medicine, University of Perugia, Perugia

    S. Marzotti, S. Romagnoli & A. Falorni

  3. Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine, University of Turin, C.so Dogliotti 14, 10126, Turin, Italy

    M. Balbo, E. Marinazzo, R. Berardelli, A. Benso, E. Ghigo & E. Arvat MD

  4. Department of Public Health and Microbiology, University of Turin, Turin, Italy

    G. Migliaretti

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  1. R. Giordano
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  5. E. Marinazzo
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Correspondence to E. Arvat MD.

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Giordano, R., Marzotti, S., Balbo, M. et al. Metabolic and cardiovascular profile in patients with Addison’s disease under conventional glucocorticoid replacement. J Endocrinol Invest 32, 917–923 (2009). https://doi.org/10.1007/BF03345773

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  • DOI: https://doi.org/10.1007/BF03345773

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