Heureux F, Maiter D, Boutsen Y, Devogelaer J P, Jamart J, Donckier J
Services de Médecine Interne Générale et d'Endocrinologie, Cliniques universitaires UCL de Mont-Godinne, Yvoir.
Ann Endocrinol (Paris). 2000 Sep;61(3):179-83.
Assessment of patients on steroid replacement therapy is important to avoid the consequences of overtreatment such as osteoporosis. The aim of this prospective study is to evaluate the severity and the etiology of osteopenia in 24 patients (15 women, 9 men) with Addison's disease receiving 30 mg hydrocortisone. Mean age of patients was 55 15 years. Osteoporosis, diagnosed by the measurement of bone mineral density (BMD) at the level of lumbar spine and right hip, was found in 58% of patients, i.e. in 10 women and 4 men. The latter had normal testosterone levels while seven women had an early menopause, the etiology of their Addison's disease being autoimmune. Three were on hormonotherapy. Correlations were found between BMD in the femoral neck and hip and the dose of hydrocortisone (mg/m(2)/day; mg/kg/day), the duration of treatment and 24 hr-cortisoluria/g creatinine. Multivariate analysis shows that 24-hr cortisoluria/g creatinine is a good predictor of BMD values. Thus, osteoporosis is frequent in Addison's disease and cortisoluria could be a useful tool to predict this complication.
对接受类固醇替代疗法的患者进行评估，对于避免诸如骨质疏松等过度治疗的后果至关重要。这项前瞻性研究的目的是评估24例接受30毫克氢化可的松治疗的艾迪生病患者（15名女性，9名男性）骨质减少的严重程度和病因。患者的平均年龄为55±15岁。通过测量腰椎和右髋部的骨密度（BMD）诊断出骨质疏松症，在58%的患者中发现，即10名女性和4名男性。后者睾酮水平正常，而7名女性处于早期绝经状态，她们艾迪生病的病因是自身免疫性的。3人接受激素治疗。发现股骨颈和髋部的骨密度与氢化可的松剂量（毫克/平方米/天；毫克/千克/天）、治疗持续时间以及24小时尿皮质醇/克肌酐之间存在相关性。多变量分析表明，24小时尿皮质醇/克肌酐是骨密度值的良好预测指标。因此，骨质疏松症在艾迪生病中很常见，尿皮质醇可能是预测这种并发症的有用工具。
