Cited by 96Adrenal Hormones and DisordersHormonal and reproductive studiesStress Responses and Cortisol

Management of endocrine disease: risk of overtreatment in patients with adrenal insufficiency: current and emerging aspects

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Mazziotti, G, Formenti, A M, Frara, S, Roca, E, Mortini, P, Berruti, A, Giustina, A·2017·European Journal of Endocrinology

Abstract

The effects of long-term replacement therapy of adrenal insufficiency (AI) are still a matter of controversy. In fact, the established glucocorticoid replacement regimens do not completely reproduce the endogenous hormonal production and the monitoring of AI treatment may be a challenge for the lack of reliable clinical and biochemical markers. Consequently, several AI patients are frequently exposed to relative glucocorticoid excess potentially leading to develop chronic complications, such as diabetes mellitus, dyslipidemia, hypertension and fragility fractures with consequent impaired QoL and increased mortality risk. This review deals with the pathophysiological and clinical aspects concerning the over-replacement therapy of primary and secondary AI.

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  • Overreplacement of glucocorticoids has been associated with increased mortality.

    “Overreplacement of glucocorticoids has been associated with increased mortality (50), and under-replacement may lead to adrenal crises and hypoglycaemia.”

    From Hypoglycaemia in adrenal insufficiency (2023) · cites this paper as [50]

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  1. Addison T. On the constitutional and local effects of disease of the supra-renal capsules. 1855. Reproduced in Dr. Addison's works. New Sydenham Society 1868 36 211-239.

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Authors
Mazziotti, G., Formenti, A. M., Frara, S., Roca, E., Mortini, P., Berruti, A., & Giustina, A.
Affiliations
  • Azienda Ospedaliera Carlo Poma (IT)
  • University of Brescia (IT)
  • Vita-Salute San Raffaele University (IT)
Corresponding author
Giustina, A
Venue
European Journal of Endocrinology
Published
2017-11
Volume
177
Issue
5
Pages
R231-R248
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
OpenAlex
W2622070501
Cited by
96
References
155
Citations by year
2026: 6 · 2025: 8 · 2024: 16 · 2023: 7 · 2022: 15 · 2021: 13 · 2020: 13 · 2019: 4 · 2018: 10 · 2017: 2
FWCI
1.16
Type
journal article
Language
en
Open access
Locations
  • European Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
  • Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
  • INFM-OAR (INFN Catania) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
adrenal insufficiency, glucocorticoid replacement therapy, overtreatment, glucocorticoid excess, Addison's disease, secondary adrenal insufficiency, diabetes mellitus, dyslipidemia, hypertension, fragility fractures, quality of life, mortality risk, treatment monitoring
MeSH terms
Medical Overuse, Adrenal Insufficiency, Humans, Hydrocortisone, Risk Factors, Disease Management, Hormone Replacement Therapy

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