Table 1.
Studies evaluating glycometabolic effects of glucocorticoid therapeutic regimens in Secondary Adrenal Insufficiency (SAI).
| Authors | Study design | SAI/PAI/CAH | Patients with altered glucose homeostasis | Higher dose vs. lower dose of GCs | switch to od-MRHC | PAI vs. SAI | |
|---|---|---|---|---|---|---|---|
| Dunne FP (44) | Clinical trial | 13/0/0 | - | → Fasting blood glucose → HbA1c → Body weight |
- | ||
| McConnell EM (52) | Clinical trial | 15/0/0 | - | → Insulin resistance | - | ||
| Filipsson H (40) | Observational study | 1707/0/0 | 55/1707 | ↑ BMI at higher dose ↑ Waist circumference at higher dose |
- | ||
| Danilowicz K (45) | Clinical trial | 11/0/0 | - | ↓ Total body fat ↓ Abdominal fat → Fasting blood glucose → HOMA index |
- | ||
| Bleicken B (47) | Observational study | 140/194/0 | - | → BMI | N/A | ||
| Zueger T (48) | Retrospectivestudy | 105/0/0 | 12/105 | ↑ BMI at higher dose | - | ||
| Petersons CJ (43) | Clinical trial | 17/0/0 | - | → Insulin sensitivity → Insulin secretion |
- | ||
| Castinetti F (46) | Observational study | 122/79/0 | 25/201 | → Fasting blood glucose → Insulin secretion → BMI |
BMI: SAI>PAI HbA1c: PAI>SAI | ||
| Quinkler M (18) | Clinical trial | 18/26/6 | 4/50 | ↓ BMI ↓ HbA1c |
N/A | ||
| Mongioì LM (54) | Clinical trial | 9/10/0 | 5/19 | ↓ HbA1c in PAI → HbA1c in SAI → BMI |
↓ HbA1c in PAI → HbA1c in SAI |
||
| Isidori AM (19) | Randomized clinical trial | 45/44/0 | 15/89 | ↓ Body weight ↓ BMI ↓ HbA1c → Fasting blood glucose → Insulin secretion → HOMA index |
↓ BMI: SAI>PAI ↓ Bodyweight: SAI>PAI ↓ HbA1c: SAI = PAI |
||
| Guarnotta V (56) | Retrospective study | 36/13/0 | 25/49 | ↓ BMI ↓ waist circumference ↓ HbA1c ↓ Insulin secretion ↓ Insulin AUC 2h ↓ VAI ↑ DIo ↑ ISI-Matsuda |
↓ BMI: SAI = PAI ↓ Waist circumference:SAI = PAI ↓ HbA1c: SAI = PAI ↓ Insulin secretion: SAI = PAI ↓ Insulin AUC2h: SAI = PAI ↓ VAI: SAI = PAI ↑ DIo: SAI = PAI ↑ ISI-Matsuda: SAI = PAI |
SAI, secondary adrenal insufficiency; PAI, primary adrenal insufficiency; CAH, congenital adrenal hyperplasia; GCs, glucocorticoids; od-MRHC, once-daily modified-release hydrocortisone;HbA1c,glycosilated hemoglobin; BMI, body mass index; HOMAindex, homoeostatic model assessment index; AUC area under the curve; VAI, visceral adiposity index;DIo,oral disposition index; ISI-Matsuda, Matsuda index of insulin sensitivity. → no change; ↓ reduction; ↑ increase; N/A not available.