Endocrine Abstracts

Introduction: Conventional glucocorticoid replacement therapy has been suggested to increase morbidity in patients with Addison disease and fail to restore their quality of life (QOL). The aim of our study was to assess QOL in patients with Addison disease and to identify factors that determine their QOL.

Patients and methods: This cross-sectional study was carried out at the department of Endocrinology in HediChaker hospital-Sfax –Tunisia, from March 2020 to July 2021.Fifty patients with Addison disease were recruited both outpatient and hospitalization departments. Healthrelated quality of life was measured using the 36-item Short-Form Health Survey (SF-36).The questionnaire contained eight domains:physical functioning (PF), role physical (RP), bodily pain (BP) general health (GH), vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH). An overall mean score of less than 66.7 means impaired quality of life.

Results: Mean age of patients and duration of Addison disease was 49,5±13,9 years and 13,9±8,7 years.The female sex was the most affected with a sex ratio of 4. The majority of patients (72%) were unemployed.Approximately half of patients were overweight (BMI ≥ 25) (48%) and had a sedentary lifestyle (66%). All patients were on hydrocortisone replacement, taking daily 27,4±6,7 mg (15–42,1 mg). Mean cumulative hydrocortisone dose was 374,636±283,821 mg (60–1184, 94 mg). Overall SF-36 scores were on average 65,7±4,1.QOL was impaired in 65% of patients. Both daily and cumulative hydrocortisone doses were higher in patients having an impaired QOL but without significant difference. No correlation was identified between QOL and duration of glucocorticoid replacement therapy.

Conclusion: Patients with Addison disease experience significant impairment in their health QOL, which is linked particularly to metabolic and bone consequences of long-term glucocorticoid replacement therapy. The assessment of QOL in patients with Addison disease may help to ameliorate patient’s wellbeing.