ECE2022 Poster Presentations Calcium and Bone (68 abstracts)
Effect of glucocorticoid replacement therapy on bone mineral density in addison disease
Dhoha Ben Salah , Khouloud Boujelben , Kawthar El Arbi , Faten Haj Kacem Akid , Siddiqa Soomauroo , Mouna Mnif , Nadia Charfi , Mnif Fatma , Nabila Rekik Majdoub , Mouna Elleuch & Mohamed Abid
Hedi Chaker Hospital, Department of Endocrinology, Sfax, Tunisia
Introduction: Addison disease is associated with high risk of fractures and low bone mineral density. Causes are complex, including supraphysiologic glucocorticoid replacement therapy and concomitant autoimmune disorders. The aim of our study is to assess the influence of glucorticoid replacement therapy on bone mineral density in patients with Addison disease.
Patients and methods: Descriptive and analytical cross- sectional study including 50 patients with Addison disease. The incidence of osteoporosis and osteopenia were analyzed.
Results: The mean age of patients was 49,5±13,9 years (40 females versus 10 males). Average duration of the disease was 13,9±8,7 years (5-35 years). All patients were on hydrocortisone replacement, taking daily 27,4±6,7 mg (15-42,1 mg) corresponding to 0,388±0,128 mg/kg. Thirty-nine (78 %) patients received a mean daily dose of hydrocortisone greater than 11 mg/m2. Mean cumulative hydrocortisone dose was 374,636±283,821 mg (60 – 1184, 94 mg). The mean alkaline phosphatase level was 77,2±28,5 I/l (15-190 IU/l). A total of 9 patients (18 %) had elevated alkaline phosphatase level after a mean disease duration of 14,9±8,4 years and a mean cumulative hydrocortisone dose of 413;4±348 mg/day. Mean mineral bone density at lumbar site and femoral neck was 0,928±0,174 g/cm2 (0,596-1,287 g/cm2) and 0,945±0,145 g/cm2, respectively. Mean T-score at lumbar site and femoral neck was -1,61±1,06 and -1,18±1,33, respectively. Twenty-four (48 %) patients had reduced bone mineral density on osteodensitometry (less than 2 standard deviations [SD] of the mean value of an age-matched reference population). Twelve (24%) patients had osteoporosis.
Conclusion: Glucocorticoid replacement therapy in Addison disease may induce bone loss. Thus, glucocorticoid therapy must be adjusted to the lowest tolerable dose and regular measurement
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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