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    Low-dose hydrocortisone (HC) replacement therapy is associated with improved bone remodeling balance in hypopituitary subjects

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    Authors
    Behan, L A
    Kelleher, G
    Hannon, M J
    Brady, J J
    Rogers, B
    Tormey, W
    Smith, D
    Thompson, C J
    McKenna, M J
    Agha, A
    Issue Date
    2011-06
    
    Metadata
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    Citation
    Endocrine Reviews (2011) 32:3 Meeting Abstracts. : June 2011
    Journal
    Endocrine Reviews
    URI
    http://hdl.handle.net/10147/240292
    Additional Links
    http://edrv.endojournals.org/cgi/content/meeting_abstract/32/03_MeetingAbstracts/P2-411?sid=37055afe-3553-4704-b98c-a11f11a2777b
    Abstract
    The effect of commonly used glucocorticoid replacement regimens on bone health in hypopituitary subjects is not well known. We aimed to assess the effect of 3 hydrocortisone (HC) replacement dose regimens on bone turnover in this group.10 hypopituitary men with severe ACTH deficiency were randomised in a crossover design to 3 HC dose regimens, Dose A (20mg mane, 10mg tarde), Dose B (10mg twice daily) and Dose C (10mg mane, 5mg tarde). Following 6 weeks of each regimen participants underwent fasting sampling of bone turnover markers.Data from matched controls were used to produce a Z score for subject bone formation and resorption markers and to calculate the bone remodeling balance (formation Z score-resorption Z score) and turnover index ((formation Z + resorption Z)/2). A positive bone remodeling balance with increased turnover is consistent with a favourable bone cycle. Data are expressed as median (range).The Pro Collagen Type 1 Peptide (PINP) bone formation Z-score was significantly increased in Dose C, (1.805 (-0.6-10.24)) compared to Dose A (0.035 (-1.0-8.1)) p<0.05 while there was no difference in the C-terminal crosslinking telopeptide (CTx) resorption Z score. The bone remodeling balance was significantly lower for dose A -0.02 (-1.05-4.12) compared to dose C 1.13 (0.13-6.4) (p<0.05). Although there was a trend to an increased bone turnover index with the lower dose regimen, this was not statistically significant.Low dose HC replacement (10mg mane/5 mg tarde) was associated with increased bone formation and improved bone remodeling balance which is associated with a more favourable bone cycle. This may have a long term beneficial effect on bone health.
    Item Type
    Conference Presentation
    Language
    en
    Collections
    Beaumont Hospital

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