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Endocrine
Published in: Endocrine 2/2015

Open Access 01-03-2015 | Original Article

Steroid replacement in primary adrenal failure does not appear to affect circulating adipokines

Authors: Marta Fichna, Piotr Fichna, Maria Gryczyńska, Agata Czarnywojtek, Magdalena Żurawek, Marek Ruchała

Published in: Endocrine | Issue 2/2015

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Abstract

Despite continuous efforts for an optimal steroid replacement, recent observations suggest increased cardiometabolic risk and related mortality in primary adrenal insufficiency (PAI). Adipokines are peptides from the adipose tissue, markers of cardiometabolic dysfunction. This study was aimed to evaluate serum levels of adipokines: leptin, adiponectin, and resistin in PAI during conventional steroid substitution. The analysis comprised 63 patients (mean age 42.7 ± 14.1 years) and 63 healthy controls. Serum adipokines, lipid profile, and plasma glucose were assessed in both cohorts. ACTH, serum insulin, HOMA-IR, DHEA-S, cortisol and 24 h urinary free cortisol were determined in PAI. Body mass composition was analyzed by Dual-Energy X-ray Absorptiometry. Mean BMI in the control group was 24.1 ± 3.9 kg/m2 and 23.7 ± 3.9 kg/m2 in the PAI cohort. Serum leptin and adiponectin levels were similar in both groups, whereas resistin appeared significantly lower among affected subjects (p = 0.0002). Its levels were weakly correlated with HOMA-IR (p = 0.048). Leptin was independently correlated with fasting insulin, HOMA-IR, BMI, and body fat (p < 0.001). At the multiple regression analysis only weight (p = 0.017), total and HDL cholesterol (p < 0.001) appeared significant predictors of adiponectin level. No adipokine correlations with serum cortisol or daily hydrocortisone dose were found. Patients receiving DHEA substitution displayed lower leptin and adiponectin levels (p < 0.05). In conclusion, our study did not provide evidence of an adverse adipokine profile in patients with PAI under conventional glucocorticoid replacement. Serum adipokines in treated PAI follow similar correlations to those reported in healthy subjects. Further prospective studies are warranted to verify and explain plausible excess of cardiovascular mortality in PAI.
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Metadata
Title
Steroid replacement in primary adrenal failure does not appear to affect circulating adipokines
Authors
Marta Fichna
Piotr Fichna
Maria Gryczyńska
Agata Czarnywojtek
Magdalena Żurawek
Marek Ruchała
Publication date
01-03-2015
Publisher
Springer US
Published in
Endocrine / Issue 2/2015
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-014-0388-6

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