Quinkler, M; Ekman, B; Marelli, C; Uddin, S; Zelissen, P; Murray, RD; Ekman, B; ... EU-AIR Investigators, .; + view all Quinkler, M; Ekman, B; Marelli, C; Uddin, S; Zelissen, P; Murray, RD; Ekman, B; Nilsson, A; Zelissen, P; van Beek, A; Feelders, R; Murray, RD; Pearce, S; Drake, W; Toogood, A; Trainer, P; Grossman, A; Bouloux, PM; Quinkler, M; Kienitz, T; Beuschlein, F; Stalla, G; Hahner, S; Badenhoop, K; Schï fl, C; EU-AIR Investigators, .; - view fewer (2017) Prednisolone is associated with a worse lipid profile than hydrocortisone in patients with adrenal insufficiency. Endocrine Connections , 6 (1) pp. 1-8. 10.1530/EC-16-0081.

Preview	Text (Published article) 1.full.pdf - Published Version Download (1MB) | Preview
Preview	Text (Supplementary tables) supplementary_tables.pdf Download (54kB) | Preview

Abstract

Objective: Prednisolone is used as glucocorticoid replacement therapy for adrenal insufficiency (AI). Recent data indicate that its use in AI is associated with low bone mineral density. Data on risk factors for cardiovascular disease in patients with AI treated with prednisolone are scarce, despite this condition being the predominant cause of excess mortality. We aimed to address this question using real-world data from the European Adrenal Insufficiency Registry (EU-AIR). // Design/methods: EU-AIR, comprising of 19 centres across Germany, the Netherlands, Sweden and the UK, commenced enrolling patients with AI in August 2012. Patients receiving prednisolone (3–6 mg/day, n = 50) or hydrocortisone (15–30 mg/day, n = 909) were identified and grouped at a ratio of 1:3 (prednisolone:hydrocortisone) by matching for gender, age, duration and type of disease. Data from baseline and follow-up visits were analysed. Data from patients with congenital adrenal hyperplasia were excluded. // Results: Significantly higher mean ± S.D. total (6.3 ± 1.6 vs 5.4 ± 1.1 mmol/L; P = 0.003) and low-density lipoprotein (LDL) cholesterol levels (3.9 ± 1.4 vs 3.2 ± 1.0 mmol/L; P = 0.013) were identified in 47 patients on prednisolone vs 141 receiving hydrocortisone at baseline and at follow-up (P = 0.005 and P = 0.006, respectively). HbA1c, high-density lipoprotein and triglyceride levels, body mass index, systolic and diastolic blood pressure and waist circumference were not significantly different. // Conclusions: This is the first matched analysis of its kind. Significantly higher LDL levels in patients receiving prednisolone relative to hydrocortisone could predict a higher relative risk of cardiovascular disease in the former group.

Download activity - last month

Export as JSONCSVXML

Download activity - last 12 months

Export as CSVXMLJSON

Downloads by country - last 12 months

Export as CSVXMLJSON

Archive Staff Only

View Item