EYES2023 ESE Young Endocrinologists and Scientists (EYES) 2023 Oral communication 1: Adrenal Diseases (8 abstracts)
Morbidity in patients with chronic adrenal insufficiency – cardiovascular risk factors and hospitalization rate compared to population based controls
Irina Chifu 1 , Marcus Quinkler 2 , Barbara Altieri 3 , Anke Hannemann 4 , Henry Völzke 5 , Katharina Lang 6 , Nicole Reisch 7 , Christina Pamporaki 8 , Holger S. Willenberg 9 , Felix Beuschlein 10 , Stephanie Burger-Stritt 11 & Stefanie Hahner 12
1University Hospital Wuerzburg, Department of Internal Medicine I, Endocrinology and Diabetes, Würzburg, Germany; 2Endokrinologie in Charlottenburg, Endocrinology in Charlottenburg, Berlin, Germany, Endokrinologie Praxis am Stuttgarter Platz, Berlin, Germany; 3Department of Internal Medicine I, Department of Internal Medicine I, Division of Endocrinology & Diabetes, University Hospital Wuerzburg, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany; 4University Medicine Greifswald, Institute of Clinical Chemistry and Laboratory Medicine, Greifswald, Germany; 5Universitätsmedizin Greifswald, Institut Für Community Medicine, Ship/Klinisch-Epidemiologische Forschung, Greifswald, Germany; 6Institute of Metabolism and Systems Research, University of Birmingham, Institute of Metabolism and Systems Research, University of Birmingham, Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK; 7Klinikum der Universität München, Medizinische Klinik IV, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany, München, Germany; 8University Hospital Carl Gustav Carus, Technische Universität Dresden, Department of Endocrinology, Dresden, Germany; 9Division of Endocrinology and Metabolism, Rostock University Medical Center, University of Rostock, Rostock, Germany; 10Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München, Germany, Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland, Zürich, Switzerland; 11University Hospital of Wuerzburg, Endocrinology and Diabetes Unit, Department of Medicine I, Würzburg, Sweden; 12University Hospital Würzburg, Endocrinology and Diabetology, Division of Endocrinology and Diabetes, Würzburg, Germany.
Objective: Patients with adrenal insufficiency (AI) have been found to have increased cardiovascular morbidity, partly associated with nonphysiologic glucocorticoid replacement.
Design: We included two separate cohorts (cohort 1 and 2) of patients with chronic primary and secondary AI under standard replacement therapy and compared them to two age- and sex-matched population-based studies (SHIP-TREND/DEGS). Patient cohort 1 comprised 389 individuals assessed by questionnaires, cohort 2 included 197 patients participating in a longitudinal patient registry. Odds ratios with 95% CI for hypertension, hyperlipidaemia/HLP, type 2 diabetes/T2DM, obesity and hospitalization with adjustment for confounders were evaluated by logistic regression
Results: Patient cohort 1 had significantly lower ORs for obesity (0.5 (0.3–0.6), P<0.001) and hypertension (0.4 (0.3–0.6), P<0.001) compared to SHIP-TREND and for obesity (0.6 (0.5–0.9), P=0.003), hypertension (0.4 (0.3–0.6), P<0.001) and HLP (0.5 (0.4–0.7), P<0.001) compared to DEGS. In cohort 2, ORs were significantly lower for HLP compared to both SHIP-TREND (0.3 (0.2–0.6), P<0.001) and DEGS (0.3 (0.2–0.5), P<0.001) and for hypertension (0.7 (0.5–0.9), P=0.04) compared to SHIP-TREND. In patients with SAI from cohort 2, ORs for hypertension (2.5 (1.4–4.5), P=0.002) and obesity (1.9 (1.1–3.1), P=0.02) were significantly higher compared to DEGS, whereas ORs for HLP were significantly lower compared to both SHIP (0.3 (0.1–0.7), P=0.006) and DEGS (0.3 (0.1–0.8), P=0.008). ORs for hospitalization were significantly higher in both patient cohorts.
Conclusion: In most of our AI patients treated with conventional glucocorticoid doses, the risk for T2DM, obesity, hypertension, and HLP was not increased. The number of hospitalizations was significantly higher in AI patients compared to controls, which might reflect increased susceptibility but also a more proactive management of concomitant diseases by physicians and patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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