Incidence and Treatment of Hyperlipidemia in Primary and Secondary Adrenal Insufficiency
Although hyperlipidemia occuring in hypopituitarism has been known for a long time, only sporadic reports are available. Recently a survey on 333 patients with hypopituitarism reported a shortened life expectancy in these patients mainly because of vascular disorders. As hyperlipidemia is a major risk factor for vascular disease we investigated the incidence of hyperlipidemia in 23 patients with primary and 35 patients with secondary (due to diseases of the pituitary gland) adrenal insufficiency. All patients had been substituted for deficient hormones according to generally accepted rules. Hypercholesterolemia was the dominant lipid disorder and plasma cholesterol levels above 250 mg/dl occured in more than 60% of the patients studied as compared to 20–30% reported in German and North American populations. 13 patients with severe hyperlipidemia consented to treatment with diet, colestipol or fenofibrate. They responded well and plasma lipid levels could be normalized. The high prevalence of hyperlipidemia may be one major factor for the diminished life expectancy in patients with hypopituitarism (and probably also with primary adrenal insufficiency) and should thus be treated, although the longterm benefit of treatment has not yet been established.
KeywordsCholesterol Cortisol Electrophoresis Triglyceride Hypothyroidism
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