Recovery of Adrenal Function in Patients with Glucocorticoids Induced Secondary Adrenal Insufficiency
Endocrinology and Metabolism
;
: 153-160, 2016.
Article
in English
| WPRIM
| ID: wpr-116057
ABSTRACT
BACKGROUND:
The chronic use of glucocorticoids (GC) suppresses function of the hypothalamic-pituitary-adrenal axis and often results in secondary adrenal insufficiency (AI). The present study aimed to determine the recovery rate of adrenal function in patients with secondary AI within 1 to 2 years and to assess the factors predictive of adrenal function recovery.METHODS:
This was a retrospective observational study that enrolled patients diagnosed with GC-induced secondary AI between 2007 and 2013. AI was defined by peak serum cortisol levels <18 µg/dL during a standard-dose short synacthen test (SST). A follow-up SST was performed after 1 to 2 years, and responders were defined as those with adrenocorticotropic hormone (ACTH)-stimulated peak serum cortisol levels ≥18 µg/dL.RESULTS:
Of the total 34 patients diagnosed with GC-induced secondary AI at first, 20 patients (58.8%) recovered normal adrenal function by the time of the follow-up SST (median follow-up period, 16.5 months). Although the baseline serum ACTH and cortisol levels at the first SST did not differ between responders and non-responders, the incremental cortisol response during the first SST was higher in responders than that of non-responders (7.88 vs. 3.56, P<0.01). Additionally, higher cortisol increments during the first SST were an independent predictive factor of the adrenal function recovery (odds ratio, 1.58; 95% confidence interval, 1.02 to 2.46; P<0.05).CONCLUSION:
In the present study, adrenal function recovery was achieved frequently in patients with GC-induced secondary AI within 1 to 2 years. Additionally, an incremental cortisol response at the first SST may be an important predictive factor of adrenal function recovery.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Axis, Cervical Vertebra
/
Hydrocortisone
/
Retrospective Studies
/
Follow-Up Studies
/
Adrenal Insufficiency
/
Adrenocorticotropic Hormone
/
Recovery of Function
/
Observational Study
/
Glucocorticoids
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Endocrinology and Metabolism
Year:
2016
Type:
Article
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