Endocrine Abstracts

Introduction: Inappropriate glucocorticoid replacement therapy results in higher mortality rates in patients with Addison disease (AD), predominantly due to higher prevalence of cardiovascular diseases, disturbed glycometabolic state and altered anthropometric parameters. The aim of this study was to assess the impact of life-long corticosteroid exposure on anthropometric parameters in patients with AD.

Patients and Methods: This Tunisian cross-sectional study was conducted in the Endocrinology department of Hedi Chaker University hospital, Sfax, Tunisia, from March 2020 to July 2021, including 50 patients followed for AD for at least 5 years. Anthropometric parameters during clinical controls and at time of the study were recorded. Predictive factors of altered anthropometric parameters were assessed.

Results: Patients had a median age of 49.5±13.9 years (18-87 years) and a disease duration with a mean of 13.9±8.7 years (5-35 years). The mean hydrocortisone dose was 27.4±6.7 mg/day. The mean cumulative dose was 374.636±283.821 mg. The average weight was 72.5 kg (62-107 kg). Seventy percent of patients developed progressive weight gain that was more marked during the first-year follow-up with a mean of 7.4 kg. Average body mass index (BMI) was 28.1 kg/m^² (21.2-45.8 kg/m^²). Overweight and obesity were recorded in 48% and 26% of patients, respectively. There was no significant correlation between BMI and disease duration nor glucocorticoid replacement dose. Mean waist circumference was 107±11.8 cm (65-121 cm) for woman and 105.1±9.6 cm (64-119 cm) for men. Android fat distribution was depicted in 60% of patients vs only 12% at time of diagnosis. Those patients received higher daily glucocorticoid dose (26.1±7 mg/day vs 24.6 ±6.1 mg/day, P=0.7). As well, android fat distribution was significantly correlated with cumulative glucocorticoid dose (452.2±301.7 mg/day vs 241.1±264.2 mg/day, P=0.02).

Conclusion: Conclusively, patients with AD taking long-term glucocorticoid therapy may experience altered anthropometric parameters. Consequently, it seems crucial to ensure regular monitoring of those patients in order to reduce cardiovascular complications.