Aulinas Anna, Webb Susan M
Endocrinology/Medicine Departments, Sant Pau Biomedical Research Institute, Hospital de Sant Pau, Universitat Autònoma de Barcelona, C/Sant Antoni Maria Claret, 167, 08025-Barcelona, Spain.
Expert Rev Pharmacoecon Outcomes Res. 2014 Dec;14(6):873-88. doi: 10.1586/14737167.2014.963559. Epub 2014 Sep 25.
Adrenal insufficiency (AI) is characterized by a deficient production of glucocorticoids with or without associated mineral corticoid and/or adrenal androgen deficiencies. Despite the low prevalence of AI, its impact on the affected patient is very high, and can be life-threatening disease if not adequately treated. Several glucocorticoid treatment regimens are available, but none is capable of perfectly imitating the cortisol circadian rhythm. Cortisol rhythmicity and treatment of other possible concomitant conditions often associated (e.g., autoimmune disorders and panhypopituitarism) are essential to improve outcome of AI. Morbidity often present in treated AI include an unhealthy metabolic profile, bad quality of sleep, infertility, sexual dysfunction and worse health-related quality of life. This review focuses on psychological morbidity and impaired quality of life in patients with primary or secondary AI of any origin, including a special section devoted to congenital adrenal hyperplasia.
肾上腺功能不全（AI）的特征是糖皮质激素分泌不足，伴有或不伴有相关的盐皮质激素和/或肾上腺雄激素缺乏。尽管AI的患病率较低，但其对受影响患者的影响非常大，如果治疗不当，可能会成为危及生命的疾病。目前有几种糖皮质激素治疗方案，但没有一种能够完美模拟皮质醇的昼夜节律。皮质醇节律以及对其他常伴随的可能病症（如自身免疫性疾病和全垂体功能减退症）的治疗对于改善AI的治疗效果至关重要。接受治疗的AI患者常出现的病症包括不健康的代谢状况、睡眠质量差、不孕、性功能障碍以及与健康相关的生活质量较差。本综述重点关注任何病因的原发性或继发性AI患者的心理病症和生活质量受损情况，包括专门论述先天性肾上腺增生症的章节。
