[Cardiovascular and metabolic impact of glucocorticoid substitution therapy in patients with Addison's disease].

Abstract

Recent studies conducted in patients with Addison's disease (AD) highlighted that this disease, even after treatment, is a significant cause of morbi-mortality. This study aims to determine the cardiovascular and metabolic deleterious impact of long-course glucocorticoid substitution therapy. We conducted a retrospective study of 28 patients with treated Addison's disease evolving for more than 15 years. The average age of patients was 58, 53 years, with a female predominance (65%). The average follow-up period was 17, 87 years. Initial dose of hydrocortisone was 32, 5 mg/day (20.52 mg/m2) and 27, 9 mg/day (16,41mg/m2) at the time of the study. The prevalence of the metabolic syndrome (MS) in patients with AM was 35.71% after a period of treatment longer than 15 years. At the end of the follow-up period, 28.57% of patients were obese; 25% of patients had developed AH (arterial hypertension) and type 2 diabetes. The prevalence of dyslipidemia went from 3.57% to 42.85%. Only one patient had myocardial infarction at 25-year follow-up. Factors favoring the onset of MS in our study were history of disease and weight loss at the moment of diagnosis. Adjustment of substitution therapy is a challenge in patients with Addison's disease due to morbi-mortality associated with overdose. A regular follow-up and a personalized therapeutic approach are necessary to improve patients' prognosis.

• Authors: Dhoha Ben Salah, Nadia Charfi, Mouna Elleuch, Faten Hadj Kacem, Nabila Rekik, Mouna Mnif, Fatma Mnif, Mohamed Abid
• Journal: The Pan African medical journal (Pan Afr Med J) Vol. 30 Pg. 251 ( 2018) ISSN: 1937-8688 [Electronic] Uganda
• Vernacular Title: Répercussions métaboliques et cardiovasculaires de la substitution glucocorticoïde au cours de la maladie d’Addison.
• PMID: 30627312 (Publication Type: Case Reports, Journal Article)

Chemical References

• Glucocorticoids
• Hydrocortisone

Topics

• Addison Disease (complications, drug therapy)
• Adult
• Aged
• Aged, 80 and over
• Diabetes Mellitus, Type 2 (epidemiology)
• Dose-Response Relationship, Drug
• Dyslipidemias (epidemiology)
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage, adverse effects)
• Hormone Replacement Therapy (methods)
• Humans
• Hydrocortisone (administration & dosage, adverse effects)
• Hypertension (epidemiology)
• Male
• Metabolic Syndrome (epidemiology)
• Middle Aged
• Prevalence
• Prognosis
• Retrospective Studies
• Time Factors