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

Summary 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 stud...

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Bibliographic Details
Published in:Clinical endocrinology (Oxford) 2013-02, Vol.78 (2), p.197-203
Main Authors: Han, T. S., Stimson, R. H., Rees, D. A., Krone, N., Willis, D. S., Conway, G. S., Arlt, W., Walker, B. R., Ross, R. J.
Format: Article
Language:English
Subjects:
Adrenal Hyperplasia, Congenital - drug therapy
Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
Adult
Biological and medical sciences
Cross-Sectional Studies
Dexamethasone - administration & dosage
Dexamethasone - therapeutic use
Drug Therapy, Combination
Endocrinopathies
Energy Metabolism - drug effects
Female
Fundamental and applied biological sciences. Psychology
Humans
Hydrocortisone - administration & dosage
Hydrocortisone - therapeutic use
Male
Medical sciences
Middle Aged
Miscellaneous
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Public health. Hygiene
Public health. Hygiene-occupational medicine
Vertebrates: endocrinology
Young Adult
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Summary:Summary 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 and 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 with 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 
ISSN:0300-0664
1365-2265
DOI:10.1111/cen.12045