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Cited by 29Adrenal Hormones and DisordersHormonal and reproductive studiesHormonal Regulation and Hypertension

Cardiovascular Risk Factors in Patients with Addison's Disease: A Comparative Study of South African and Swedish Patients

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Ross, Ian Louis, Bergthorsdottir, Ragnhildur, Levitt, Naomi, Dave, Joel Alex, Schatz, Desmond, Marais, David, Johannsson, Gudmundur·2014·PLoS ONE
DOI 10.1371/journal.pone.0090768PMC PMC3948337
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Abstract

BACKGROUND: Patients with Addison's disease (AD) in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD). Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. METHODS: In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden) matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP) and adiponectin were studied. RESULTS: All patients were Caucasian and the majority were women N = 36 (65.5%). Mean (standard deviation; SD) ages of the Swedish and South African patients were 52.9 (13.0) and 52.6 (14.4) years and BMI 25.3 (3.2) and 25.8 (4.1) kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1) versus 24.3 (8.0) mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR) triglycerides (TG) [1.59 (1.1-2.46) versus 0.96 (0.74-1.6) mmol/l; p<0.001], total cholesterol (TC) [6.02(1.50) versus 5.13 (0.87) mmol/l; p<0.001], LDL-C [4.43 (1.44) versus 2.75 (0.80) mmol/l; p<0.001] and median hs-CRP [2.15 (0.93-5.45) versus 0.99 (0.57-2.10) mg/L; p<0.003] and lower HDL-C [0.80 (0.40) versus 1.86 (0.46) mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. CONCLUSIONS: South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors.

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  • Primary hypertension may also be present in PAI.

    “Primary hypertension may also be present in PAI (111).”

    From Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [111]

    The Results report that approximately 20% of patients in both Addison’s disease cohorts had hypertension. The paper does not identify that hypertension as primary rather than secondary, so it supports the coexistence of hypertension with PAI but not the specified type. (LLM, conf=0.84)

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Authors
Ross, I. L., Bergthorsdottir, R., Levitt, N., Dave, J. A., Schatz, D., Marais, D., & Johannsson, G.
Affiliations
  • University of Cape Town (ZA)
  • Sahlgrenska University Hospital (SE)
  • University of Florida (US)
  • National Health Laboratory Service (ZA)
Corresponding author
Ross, Ian Louis
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2014-03-06
Volume
9
Issue
3
Pages
e90768
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0090768
PMC
PMC3948337
OpenAlex
W2077240920
Cited by
29
References
4
Citations by year
2026: 2 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 4 · 2018: 1 · 2017: 4 · 2016: 4 · 2015: 1 · 2014: 4
FWCI
3.49
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Open University of Cape Town (University of Cape Town) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Keywords
Addison's disease, cardiovascular risk factors, lipid profile, triglycerides, LDL cholesterol, HDL cholesterol, total cholesterol, C-reactive protein, adiponectin, cardiovascular disease, cross-national comparison, South Africa, Sweden, adrenal insufficiency, hypertriglyceridemia, dyslipidemia, inflammatory markers, adipokines
MeSH terms
Addison Disease, Adult, Anti-Inflammatory Agents, C-Reactive Protein, Cardiovascular Diseases, Cross-Sectional Studies, Female, Humans, Hydrocortisone, Lipids, Male, Middle Aged, Risk Factors, South Africa, Sweden, Biomarkers, Inflammation Mediators, Adiponectin

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