Glucocorticoid treatment regimen and health outcomes in adults with congenital adrenal hyperplasia

Ts Han; Rh Stimson; DA Rees; N Krone; Ds Willis; Gs Conway; W Arlt; Br Walker; Rj Ross; The United Kingdom Congenital adrenal Hyperplasia Adult Study Executive (CaHASE)

doi:10.1111/cen.12045

Glucocorticoid treatment regimen and health outcomes in adults with congenital adrenal hyperplasia

Ts Han, Rh Stimson, DA Rees, N Krone, Ds Willis, Gs Conway, W Arlt, Br Walker, Rj Ross, The United Kingdom Congenital adrenal Hyperplasia Adult Study Executive (CaHASE)

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Abstract

BACKGROUND: Adults with congenital adrenal hyperplasia (CAH) are treated with a wide variety of glucocorticoid treatment regimens. OBJECTIVE, DESIGN AND METHODS: To test whether drug dose and timing of glucocorticoid treatment regimen impacts on health outcomes. This was a cross-sectional study of 196 adult CAH patients in whom treatment and health outcomes were measured. Glucocorticoid dose was converted to prednisolone dose equivalent (PreDEq) using three published formulae. Associations between the type of glucocorticoid regimen or PreDEq with specific health outcome variables were tested using partial correlation and principal components analysis (PCA). RESULTS: Patients on dexamethasone had lower androgens and ACTH but greater insulin resistance compared to those receiving hydrocortisone or prednisolone. Dexamethasone dose and once daily administration were associated with insulin resistance. Partial correlation analysis adjusted for age and sex showed PreDEq weakly correlated (r

Original language	English
Journal	Clinical Endocrinology
DOIs	https://doi.org/10.1111/cen.12045
Publication status	Published - 2012

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title = "Glucocorticoid treatment regimen and health outcomes in adults with congenital adrenal hyperplasia",

abstract = "BACKGROUND: Adults with congenital adrenal hyperplasia (CAH) are treated with a wide variety of glucocorticoid treatment regimens. OBJECTIVE, DESIGN AND METHODS: To test whether drug dose and timing of glucocorticoid treatment regimen impacts on health outcomes. This was a cross-sectional study of 196 adult CAH patients in whom treatment and health outcomes were measured. Glucocorticoid dose was converted to prednisolone dose equivalent (PreDEq) using three published formulae. Associations between the type of glucocorticoid regimen or PreDEq with specific health outcome variables were tested using partial correlation and principal components analysis (PCA). RESULTS: Patients on dexamethasone had lower androgens and ACTH but greater insulin resistance compared to those receiving hydrocortisone or prednisolone. Dexamethasone dose and once daily administration were associated with insulin resistance. Partial correlation analysis adjusted for age and sex showed PreDEq weakly correlated (r ",

author = "Ts Han and Rh Stimson and DA Rees and N Krone and Ds Willis and Gs Conway and W Arlt and Br Walker and Rj Ross and {The United Kingdom Congenital adrenal Hyperplasia Adult Study Executive (CaHASE)}",

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T1 - Glucocorticoid treatment regimen and health outcomes in adults with congenital adrenal hyperplasia

AU - Han, Ts

AU - Stimson, Rh

AU - Rees, DA

AU - Krone, N

AU - Willis, Ds

AU - Conway, Gs

AU - Arlt, W

AU - Walker, Br

AU - Ross, Rj

AU - The United Kingdom Congenital adrenal Hyperplasia Adult Study Executive (CaHASE)

PY - 2012

Y1 - 2012

N2 - BACKGROUND: Adults with congenital adrenal hyperplasia (CAH) are treated with a wide variety of glucocorticoid treatment regimens. OBJECTIVE, DESIGN AND METHODS: To test whether drug dose and timing of glucocorticoid treatment regimen impacts on health outcomes. This was a cross-sectional study of 196 adult CAH patients in whom treatment and health outcomes were measured. Glucocorticoid dose was converted to prednisolone dose equivalent (PreDEq) using three published formulae. Associations between the type of glucocorticoid regimen or PreDEq with specific health outcome variables were tested using partial correlation and principal components analysis (PCA). RESULTS: Patients on dexamethasone had lower androgens and ACTH but greater insulin resistance compared to those receiving hydrocortisone or prednisolone. Dexamethasone dose and once daily administration were associated with insulin resistance. Partial correlation analysis adjusted for age and sex showed PreDEq weakly correlated (r

AB - BACKGROUND: Adults with congenital adrenal hyperplasia (CAH) are treated with a wide variety of glucocorticoid treatment regimens. OBJECTIVE, DESIGN AND METHODS: To test whether drug dose and timing of glucocorticoid treatment regimen impacts on health outcomes. This was a cross-sectional study of 196 adult CAH patients in whom treatment and health outcomes were measured. Glucocorticoid dose was converted to prednisolone dose equivalent (PreDEq) using three published formulae. Associations between the type of glucocorticoid regimen or PreDEq with specific health outcome variables were tested using partial correlation and principal components analysis (PCA). RESULTS: Patients on dexamethasone had lower androgens and ACTH but greater insulin resistance compared to those receiving hydrocortisone or prednisolone. Dexamethasone dose and once daily administration were associated with insulin resistance. Partial correlation analysis adjusted for age and sex showed PreDEq weakly correlated (r

U2 - 10.1111/cen.12045

DO - 10.1111/cen.12045

M3 - Article

C2 - 22998134

SN - 0300-0664

JO - Clinical Endocrinology

JF - Clinical Endocrinology

ER -

Glucocorticoid treatment regimen and health outcomes in adults with congenital adrenal hyperplasia

Abstract

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