Warwickshire Institute for the Study of Diabetes Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, United Kingdom.
Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Front Endocrinol (Lausanne). 2021 Mar 11;12:641247. doi: 10.3389/fendo.2021.641247. eCollection 2021.
To compare metabolic effects of modified release hydrocortisone (MR-HC) with standard hydrocortisone (HC) therapies in adults with Adrenal Insufficiency (AI).
Adult patients (n = 12) with AI, established on HC therapy, were recruited from Endocrinology clinics at University Hospitals Coventry and Warwickshire (UHCW), UK. Baseline (HC) metabolic assessments included fasting serum HbA1C, lipid and thyroid profiles, accurate measures of body composition (BodPod), and 24-h continuous measures of energy expenditure including Sleeping Metabolic Rate (SMR) using indirect calorimetry within the Human Metabolism Research Unit, UHCW. All participants then switched HC to MR-HC with repeat (MR-HC) metabolic assessments at 3 months. Paired-sample t-tests were used for data comparisons between HC and MR-HC assessments: P-value <0.05 was considered significant.
Following exclusion of 2 participants, analyses were based on 10 participants. Compared with baseline HC data, following 3 months of MR-HC therapy mean fat mass reduced significantly by -3.2 kg (95% CI: -6.0 to -0.4). Mean (SD) baseline HC fat mass vs repeat MR-HC fat mass: 31.9 kg (15.2) vs 28.7 kg (12.8) respectively, P = 0.03. Mean SMR increased significantly by +77 kcal/24 h (95% CI: 10-146). Mean (SD) baseline HC SMR vs repeat MR-HC SMR: 1,517 kcal/24 h (301) vs 1,594 kcal/24 h (344) respectively, P = 0.03. Mean body fat percentage reduced significantly by -3.4% (95% CI: -6.5 to -0.2). Other measures of body composition, energy expenditure, and biochemical analytes were equivalent between HC and MR-HC assessments.
In adults with AI, switching from standard HC to MR-HC associates with early metabolic benefits of reduced fat mass and increased SMR.
比较改良释放型氢化可的松（MR-HC）与标准氢化可的松（HC）疗法在肾上腺功能不全（AI）成人患者中的代谢效应。
从英国考文垂和沃里克郡大学医院（UHCW）的内分泌科招募了 12 名接受 AI 治疗的成年患者（n=12），并接受 HC 治疗。基线（HC）代谢评估包括空腹血清 HbA1C、血脂和甲状腺谱、精确的身体成分（BodPod）测量以及 24 小时持续的能量消耗测量，包括使用 UHCW 人体代谢研究单元中的间接测热法测量静息代谢率（SMR）。所有参与者随后将 HC 转换为 MR-HC，并在 3 个月时进行重复（MR-HC）代谢评估。采用配对样本 t 检验比较 HC 和 MR-HC 评估之间的数据差异：P 值<0.05 被认为具有统计学意义。
排除 2 名参与者后，基于 10 名参与者进行分析。与基线 HC 数据相比，接受 3 个月 MR-HC 治疗后，平均脂肪量显著减少了-3.2 公斤（95%CI：-6.0 至-0.4）。基线 HC 脂肪量与重复 MR-HC 脂肪量的平均值（SD）分别为 31.9 公斤（15.2）和 28.7 公斤（12.8），P=0.03。平均 SMR 显著增加了+77 千卡/24 小时（95%CI：10-146）。基线 HC SMR 与重复 MR-HC SMR 的平均值（SD）分别为 1,517 千卡/24 小时（301）和 1,594 千卡/24 小时（344），P=0.03。平均体脂肪百分比显著降低了-3.4%（95%CI：-6.5 至-0.2）。HC 和 MR-HC 评估之间的其他身体成分、能量消耗和生化分析物测量值相当。
在 AI 成人患者中，从标准 HC 转换为 MR-HC 与脂肪量减少和 SMR 增加的早期代谢获益相关。
