CONTEXT: Hypopituitarism in adults is known to be associated with deleterious effects on body composition, lipid profile and quality of life (QoL). This was attributed to GH deficiency. The potential role of glucocorticoid overreplacement had never been investigated. OBJECTIVE: To investigate whether reduction in glucocorticoid replacement dose to more physiological one could ameliorate the "AO-GHD"-attributed symptomatology in patients with hypopituitarism. Design Eleven patients with panhypopituitarism taking 20-30 mg/day of hydrocortisone, but on no GH replacement were switched to 10-15 mg of hydrocortisone daily. Both basally and 6-12 months later, their body mass index, body composition by dual-energy X-ray absorptiometry, lipid profile, and the score of quality of life, QOL-AGHDA were measured. RESULTS: Within 6-12 months of lower hydrocortisone dose, subjects lost an average of 7.1 kg of total body fat and 4.1 kg of abdominal fat. No changes were seen in lean body mass, bone mineral content and HOMA-IR. Plasma total cholesterol and triglyceride concentrations decreased significantly (< 0.05) and the QoL improved (P = 0.018). CONCLUSIONS: Our pilot study suggests that decreasing the glucocorticoid replacement dose to approximately 15 mg/day is beneficial in terms of patients' body composition, lipid profile and quality of life.
CONTEXT: Hypopituitarism in adults is known to be associated with deleterious effects on body composition, lipid profile and quality of life (QoL). This was attributed to GH deficiency. The potential role of glucocorticoid overreplacement had never been investigated. OBJECTIVE: To investigate whether reduction in glucocorticoid replacement dose to more physiological one could ameliorate the "AO-GHD"-attributed symptomatology in patients with hypopituitarism. Design Eleven patients with panhypopituitarism taking 20-30 mg/day of hydrocortisone, but on no GH replacement were switched to 10-15 mg of hydrocortisone daily. Both basally and 6-12 months later, their body mass index, body composition by dual-energy X-ray absorptiometry, lipid profile, and the score of quality of life, QOL-AGHDA were measured. RESULTS: Within 6-12 months of lower hydrocortisone dose, subjects lost an average of 7.1 kg of total body fat and 4.1 kg of abdominal fat. No changes were seen in lean body mass, bone mineral content and HOMA-IR. Plasma total cholesterol and triglyceride concentrations decreased significantly (< 0.05) and the QoL improved (P = 0.018). CONCLUSIONS: Our pilot study suggests that decreasing the glucocorticoid replacement dose to approximately 15 mg/day is beneficial in terms of patients' body composition, lipid profile and quality of life.
Authors: Michal Krsek; Josef V Silha; Jana Jezková; Václav Hána; Josef Marek; Vladimír Weiss; Jan J Stepán; Liam J Murphy Journal: Clin Endocrinol (Oxf) Date: 2004-03 Impact factor: 3.478
Authors: F P Dunne; P Elliot; M D Gammage; T Stallard; T Ryan; M C Sheppard; P M Stewart Journal: Clin Endocrinol (Oxf) Date: 1995-11 Impact factor: 3.478
Authors: Andrew R Hoffman; Joyce E Kuntze; Joyce Baptista; Howard B A Baum; Gerhard P Baumann; Beverly M K Biller; Richard V Clark; David Cook; Silvio E Inzucchi; David Kleinberg; Anne Klibanski; Lawrence S Phillips; E Chester Ridgway; Richard J Robbins; Janet Schlechte; Meeta Sharma; Michael O Thorner; Mary Lee Vance Journal: J Clin Endocrinol Metab Date: 2004-05 Impact factor: 5.958
Authors: Jose Cordoba-Chacon; Manuel D Gahete; Naveen K Pokala; David Geldermann; Maria Alba; Roberto Salvatori; Raul M Luque; Rhonda D Kineman Journal: Endocrinology Date: 2013-12-16 Impact factor: 4.736