Recovery of Adrenal Function in Patients with Glucocorticoids Induced Secondary Adrenal Insufficiency
Endocrinology and Metabolism
;
: 153-160, 2016.
Artigo
em Inglês
| 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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Vértebra Cervical Áxis
/
Hidrocortisona
/
Estudos Retrospectivos
/
Seguimentos
/
Insuficiência Adrenal
/
Hormônio Adrenocorticotrópico
/
Recuperação de Função Fisiológica
/
Estudo Observacional
/
Glucocorticoides
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Endocrinology and Metabolism
Ano de publicação:
2016
Tipo de documento:
Artigo
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