Endocrine Abstracts

Introduction: Patients with primary, secondary or tertial adrenal insufficiency are usually treated with a glucocorticoid substitution therapy adjusting dosages to align with the circadian rhythm. Despite those attempts, finding the correct dosage individually seems challenging, influenced not only by the complexity of circadian rhythms but also by various other factors. Approximately 6-8% of adrenal insufficiency patients still experience adrenal crises every year, which is associated with an increased mortality. While it is known that social circumstances significantly impact disease development, the current therapy primarily focuses on glucocorticoid substitution, which makes it necessary to implement a different approach in therapy considering physiological and sociodemographic factors.

Material and Methods: Patients with primary, secondary or tertial adrenal insufficiency were included in the study. They were handed out questionnaires to collect demographic data, quality of life, symptoms of depression and anxiety as well as social integrity and social support data. The data analysis was conducted using Excel and SPSS.

Results: 61 participants (77% females, 23% males) with primary (47.5%), secondary (47.5%), or tertiary (4.9%) adrenal insufficiency took part in this study\. The results indicate lower health-related quality of life in adrenal insufficiency patients compared to the normative sample. The collected data from the sum of the questionnaires, in particular SCL90-R, SF-36 and AddiQol, suggest a significant correlation between lower health-related quality of life, respectively depressive symptoms, and increased occurrence of adrenal crises. For better comparability, the analysis included not only the overall number of experienced adrenal crises but also the number of crises within the last year. There was no observed correlation concerning individual glucocorticoid dosage.

Conclusions: The study underscores ongoing challenges faced in the therapy of adrenal insufficiency. The results of our study confirm a networthy association between lower health-related quality of life, including depressive symptoms and inadequate social support, and an increased incidence of adrenal crises. Although glucocorticoid dosage didn’t show a significant correlation, improving social conditions may reduce substitution requirements and adrenal crises frequency, which could have a positive impact on overall well-being and disease outcomes. This study highlights the importance of considering socioeconomic and sociodemographic factors in treatment of adrenal insufficiency.