{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:18:26Z","timestamp":1788459506985,"version":"build-2803163510"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005743","name":"Universit\u00e0 Cattolica del Sacro Cuore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pituitary"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Secondary adrenal insufficiency (SAI) is a complex endocrine disorder. Glucocorticoid (GC) replacement therapy is crucial for ensuring patient survival and guaranteeing an adequate quality of life. GC replacement therapy requires a balance between undertreatment, with the consequent risk of adrenal crisis, and overtreatment, which can have long-term effects on the metabolic and cardiovascular systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, longitudinal, observational study on 140 patients affected by pituitary disease with at least 3\u00a0years of follow-up. Patients were consecutively included in the study with a ratio 1:1, considering patients affected by SAI and who were therefore on GCs replacement therapy, and patients with pituitary disease without SAI (controls).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Worsening of glucose metabolism occurred in 29 patients with SAI (64.4%) and in 16 controls (35.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Worsening of lipid metabolism occurred in 52 patients with SAI (56.5%) and in 40 controls (43.5%\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033). GC replacement therapy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014, OR: 2.3, 95%IC: 1.1\u20134.9), higher fasting glycaemia at baseline (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04, OR: 7.6, 95%IC: 2.3\u201325.4), IGT\/T2DM at baseline (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016, OR: 8.6, 95%IC: 0.8\u201357) were the main risk factors for the worsening of glucose metabolism at 3-year follow-up. TSH deficit remained the only risk factor for the worsening of lipid profile (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, OR: 2.9, 95%IC: 1.3\u20136.5).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study proved that GCs replacement therapy may be associated with a worsening of glucose metabolism, particularly in patients already affected by IGT\/T2DM. Tailored and holistic management is essential for the management of GCs replacement therapy, in patients with other metabolic disorders and pituitary hormone deficits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11102-026-01726-1","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T14:29:04Z","timestamp":1783780144000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The metabolic effects of glucocorticoid replacement therapy in patients with secondary adrenal insufficiency due to hypothalamic-pituitary diseases: results from a retrospective and longitudinal study"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9241-2392","authenticated-orcid":false,"given":"Sabrina","family":"Chiloiro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5338-9116","authenticated-orcid":false,"given":"Alessandra","family":"Vicari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Giampietro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Costanza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalinda","family":"Calandrelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Paolo","family":"Mattogno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quintino Giorgio","family":"D\u2019Alessandris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Gaudino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"De Marinis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Doglietto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Bianchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Pontecorvi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"1726_CR1","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.ando.2017.10.010","volume":"78","author":"O Chabre","year":"2017","unstructured":"Chabre O, Goichot B, Zenaty D, Bertherat J (2017) Group 1. Epidemiology of primary and secondary adrenal insufficiency: prevalence and incidence, acute adrenal insufficiency, long-term morbidity and mortality. Ann Endocrinol (Paris) 78:490\u20134. https:\/\/doi.org\/10.1016\/j.ando.2017.10.010","journal-title":"Ann Endocrinol (Paris)"},{"key":"1726_CR2","doi-asserted-by":"publisher","first-page":"115","DOI":"10.7861\/clinmed.2023-0067","volume":"23","author":"A Lewis","year":"2023","unstructured":"Lewis A, Thant AA, Aslam A, Aung PPM, Azmi S (2023) Diagnosis and management of adrenal insufficiency. Clin Med 23:115\u2013118. https:\/\/doi.org\/10.7861\/clinmed.2023-0067","journal-title":"Clin Med"},{"key":"1726_CR3","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/S2213-8587(14)70142-1","volume":"3","author":"I Bancos","year":"2015","unstructured":"Bancos I, Hahner S, Tomlinson J, Arlt W (2015) Diagnosis and management of adrenal insufficiency. Lancet Diabetes Endocrinol 3:216\u2013226. https:\/\/doi.org\/10.1016\/S2213-8587(14)70142-1","journal-title":"Lancet Diabetes Endocrinol"},{"key":"1726_CR4","doi-asserted-by":"publisher","first-page":"3888","DOI":"10.1210\/jc.2016-2118","volume":"101","author":"M Fleseriu","year":"2016","unstructured":"Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R et al (2016) Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 101:3888\u20133921. https:\/\/doi.org\/10.1210\/jc.2016-2118","journal-title":"J Clin Endocrinol Metab"},{"key":"1726_CR5","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1515\/cclm-2018-0824","volume":"57","author":"F Ceccato","year":"2019","unstructured":"Ceccato F, Scaroni C (2019) Central adrenal insufficiency: open issues regarding diagnosis and glucocorticoid treatment. Clin Chem Lab Med (CCLM) 57:1125\u20131135. https:\/\/doi.org\/10.1515\/cclm-2018-0824","journal-title":"Clin Chem Lab Med (CCLM)"},{"key":"1726_CR6","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1530\/EJE-15-1212","volume":"175","author":"G Johannsson","year":"2016","unstructured":"Johannsson G, Lennern\u00e4s H, Marelli C, Rockich K, Skrtic S (2016) Achieving a physiological cortisol profile with once-daily dual-release hydrocortisone: a pharmacokinetic study. Eur J Endocrinol 175:85\u201393. https:\/\/doi.org\/10.1530\/EJE-15-1212","journal-title":"Eur J Endocrinol"},{"key":"1726_CR7","doi-asserted-by":"publisher","first-page":"3178","DOI":"10.1210\/clinem\/dgad370","volume":"108","author":"RA Dineen","year":"2023","unstructured":"Dineen RA, Martin-Grace J, Ahmed KMS, Taylor AE, Shaheen F, Schiffer L et al (2023) Tissue glucocorticoid metabolism in adrenal insufficiency: a prospective study of dual-release hydrocortisone therapy. J Clin Endocrinol Metab 108:3178\u20133189. https:\/\/doi.org\/10.1210\/clinem\/dgad370","journal-title":"J Clin Endocrinol Metab"},{"key":"1726_CR8","doi-asserted-by":"publisher","unstructured":"Ueland GA, Husebye ES (2018) Metabolic complications in adrenal insufficiency, pp 104\u201313. https:\/\/doi.org\/10.1159\/000486004.","DOI":"10.1159\/000486004"},{"key":"1726_CR9","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnaa002","author":"SL Lightman","year":"2020","unstructured":"Lightman SL, Birnie MT, Conway-Campbell BL (2020) Dynamics of ACTH and cortisol secretion and implications for disease. Endocr Rev. https:\/\/doi.org\/10.1210\/endrev\/bnaa002","journal-title":"Endocr Rev"},{"key":"1726_CR10","doi-asserted-by":"publisher","DOI":"10.1177\/2042018819848218","author":"R Dineen","year":"2019","unstructured":"Dineen R, Thompson CJ, Sherlock M (2019) Adrenal crisis: prevention and management in adult patients. Ther Adv Endocrinol Metab. https:\/\/doi.org\/10.1177\/2042018819848218","journal-title":"Ther Adv Endocrinol Metab"},{"key":"1726_CR11","doi-asserted-by":"publisher","first-page":"R231","DOI":"10.1530\/EJE-17-0154","volume":"177","author":"G Mazziotti","year":"2017","unstructured":"Mazziotti G, Formenti AM, Frara S, Roca E, Mortini P, Berruti A et al (2017) Management of endocrine disease: risk of overtreatment in patients with adrenal insufficiency: current and emerging aspects. Eur J Endocrinol 177:R231\u2013R248. https:\/\/doi.org\/10.1530\/EJE-17-0154","journal-title":"Eur J Endocrinol"},{"key":"1726_CR12","doi-asserted-by":"publisher","unstructured":"Johannsson G, Ragnarsson O (2014) Cardiovascular and metabolic impact of glucocorticoid replacement therapy, pp 33\u201344. https:\/\/doi.org\/10.1159\/000360556.","DOI":"10.1159\/000360556"},{"key":"1726_CR13","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1007\/s11154-024-09898-6","volume":"25","author":"S Chiloiro","year":"2024","unstructured":"Chiloiro S, Vicari A, Mongelli G, Costanza F, Giampietro A, Mattogno PP et al (2024) Effects of glucocorticoid replacement therapy in patients with pituitary disease: a new perspective for personalized replacement therapy. Rev Endocr Metab Disord 25:855\u2013873. https:\/\/doi.org\/10.1007\/s11154-024-09898-6","journal-title":"Rev Endocr Metab Disord"},{"key":"1726_CR14","doi-asserted-by":"publisher","unstructured":"Mallappa A, Debono M (2016) Recent advances in hydrocortisone replacement treatment, pp 42\u201353. https:\/\/doi.org\/10.1159\/000439329.","DOI":"10.1159\/000439329"},{"key":"1726_CR15","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1153595","author":"B Harbeck","year":"2023","unstructured":"Harbeck B, Kropp P, Kreitschmann-Andermahr I (2023) Glucocorticoid replacement therapy for primary and secondary adrenal insufficiency and their impact on cognition. Front Endocrinol (Lausanne). https:\/\/doi.org\/10.3389\/fendo.2023.1153595","journal-title":"Front Endocrinol (Lausanne)"},{"key":"1726_CR16","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1530\/EJE-08-0874","volume":"160","author":"M Debono","year":"2009","unstructured":"Debono M, Ross RJ, Newell-Price J (2009) Inadequacies of glucocorticoid replacement and improvements by physiological circadian therapy. Eur J Endocrinol 160:719\u2013729. https:\/\/doi.org\/10.1530\/EJE-08-0874","journal-title":"Eur J Endocrinol"},{"key":"1726_CR17","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1530\/EJE-16-0969","volume":"176","author":"I Bancos","year":"2017","unstructured":"Bancos I, Hazeldine J, Chortis V, Hampson P, Taylor AE, Lord JM et al (2017) Primary adrenal insufficiency is associated with impaired natural killer cell function: a potential link to increased mortality. Eur J Endocrinol 176:471\u2013480. https:\/\/doi.org\/10.1530\/EJE-16-0969","journal-title":"Eur J Endocrinol"},{"key":"1726_CR18","doi-asserted-by":"publisher","first-page":"4843","DOI":"10.1210\/jc.2016-2221","volume":"101","author":"PM Stewart","year":"2016","unstructured":"Stewart PM, Biller BMK, Marelli C, Gunnarsson C, Ryan MP, Johannsson G (2016) Exploring inpatient hospitalizations and morbidity in patients with adrenal insufficiency. J Clin Endocrinol Metab 101:4843\u20134850. https:\/\/doi.org\/10.1210\/jc.2016-2221","journal-title":"J Clin Endocrinol Metab"},{"key":"1726_CR19","doi-asserted-by":"publisher","first-page":"3954","DOI":"10.1210\/jc.2006-0524","volume":"91","author":"H Filipsson","year":"2006","unstructured":"Filipsson H, Monson JP, Koltowska-H\u00e4ggstr\u00f6m M, Mattsson A, Johannsson G (2006) The impact of glucocorticoid replacement regimens on metabolic outcome and comorbidity in hypopituitary patients. J Clin Endocrinol Metab 91:3954\u20133961. https:\/\/doi.org\/10.1210\/jc.2006-0524","journal-title":"J Clin Endocrinol Metab"},{"key":"1726_CR20","doi-asserted-by":"publisher","unstructured":"Corona G, Morgado LA, Boeri L, Capogrosso P, Cocci A, Dinkelman-Smit M et al (2026) EAU guidelines on sexual and reproductive health: a summary of the 2026 recommendations for measurement and biochemical confirmation of hypogonadism. Eur Urol Focus. https:\/\/doi.org\/10.1016\/j.euf.2026.04.015.","DOI":"10.1016\/j.euf.2026.04.015"},{"key":"1726_CR21","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1159\/000491388","volume":"7","author":"L Persani","year":"2018","unstructured":"Persani L, Brabant G, Dattani M, Bonomi M, Feldt-Rasmussen U, Fliers E et al (2018) 2018 European Thyroid Association (ETA) guidelines on the diagnosis and management of central hypothyroidism. Eur Thyroid J 7:225\u2013237. https:\/\/doi.org\/10.1159\/000491388","journal-title":"Eur Thyroid J"},{"key":"1726_CR22","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s11102-025-01526-z","volume":"28","author":"MC Arlien-S\u00f8borg","year":"2025","unstructured":"Arlien-S\u00f8borg MC, Radovick S, Boguszewski MCS, Bidlingmaier M, Johannsson G, Grimberg A et al (2025) Consensus and controversies about diagnosing GH deficiency: a Delphi survey by the GH research society. Pituitary 28:57. https:\/\/doi.org\/10.1007\/s11102-025-01526-z","journal-title":"Pituitary"},{"key":"1726_CR23","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.1210\/jc.2011-0179","volume":"96","author":"ME Molitch","year":"2011","unstructured":"Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML (2011) Evaluation and treatment of adult growth hormone deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:1587\u20131609. https:\/\/doi.org\/10.1210\/jc.2011-0179","journal-title":"J Clin Endocrinol Metab"},{"key":"1726_CR24","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1038\/s41574-024-00985-x","volume":"20","author":"C Atila","year":"2024","unstructured":"Atila C, Refardt J, Christ-Crain M (2024) Arginine vasopressin deficiency: diagnosis, management and the relevance of oxytocin deficiency. Nat Rev Endocrinol 20:487\u2013500. https:\/\/doi.org\/10.1038\/s41574-024-00985-x","journal-title":"Nat Rev Endocrinol"},{"key":"1726_CR25","doi-asserted-by":"publisher","first-page":"S14","DOI":"10.2337\/dc20-S002","volume":"43","author":"Classification and Diagnosis of Diabetes","year":"2020","unstructured":"Classification and Diagnosis of Diabetes (2020) Standards of medical care in diabetes\u20142020. Diabetes Care 43:S14-31. https:\/\/doi.org\/10.2337\/dc20-S002","journal-title":"Diabetes Care"},{"key":"1726_CR26","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1016\/j.jacl.2022.09.006","volume":"16","author":"F Civeira","year":"2022","unstructured":"Civeira F, Arca M, Cenarro A, Hegele RA (2022) A mechanism-based operational definition and classification of hypercholesterolemia. J Clin Lipidol 16:813\u2013821. https:\/\/doi.org\/10.1016\/j.jacl.2022.09.006","journal-title":"J Clin Lipidol"},{"key":"1726_CR27","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","volume":"41","author":"F Mach","year":"2020","unstructured":"Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L et al (2020) 2019 ESC\/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 41:111\u2013188. https:\/\/doi.org\/10.1093\/eurheartj\/ehz455","journal-title":"Eur Heart J"},{"key":"1726_CR28","doi-asserted-by":"publisher","first-page":"101667","DOI":"10.1016\/j.beem.2022.101667","volume":"37","author":"CB Newman","year":"2023","unstructured":"Newman CB (2023) Effects of endocrine disorders on lipids and lipoproteins. Best Pract Res Clin Endocrinol Metab 37:101667. https:\/\/doi.org\/10.1016\/j.beem.2022.101667","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"1726_CR29","doi-asserted-by":"publisher","unstructured":"Graziadio C, Hasenmajer V, Venneri MA, Gianfrilli D, Isidori AM, Sbardella E (2018) Glycometabolic alterations in secondary adrenal insufficiency: does replacement therapy play a role? Front Endocrinol (Lausanne) 9. https:\/\/doi.org\/10.3389\/fendo.2018.00434.","DOI":"10.3389\/fendo.2018.00434"},{"key":"1726_CR30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2017\/3691913","volume":"2017","author":"A-H Rahvar","year":"2017","unstructured":"Rahvar A-H, Haas CS, Danneberg S, Harbeck B (2017) Increased cardiovascular risk in patients with adrenal insufficiency: a short review. Biomed Res Int 2017:1\u20135. https:\/\/doi.org\/10.1155\/2017\/3691913","journal-title":"Biomed Res Int"},{"key":"1726_CR31","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1007\/s12020-020-02571-3","volume":"72","author":"A-H Rahvar","year":"2021","unstructured":"Rahvar A-H, Riesel M, Graf T, Harbeck B (2021) Cardiovascular outcome in patients with adrenal insufficiency\u2014a therapeutic dilemma. Endocr Res 72:582\u2013585. https:\/\/doi.org\/10.1007\/s12020-020-02571-3","journal-title":"Endocr Res"},{"key":"1726_CR32","doi-asserted-by":"publisher","first-page":"2269","DOI":"10.1210\/jc.2013-4305","volume":"99","author":"CJ Petersons","year":"2014","unstructured":"Petersons CJ, Mangelsdorf BL, Thompson CH, Burt MG (2014) Acute effect of increasing glucocorticoid replacement dose on cardiovascular risk and insulin sensitivity in patients with adrenocorticotrophin deficiency. J Clin Endocrinol Metab 99:2269\u20132276. https:\/\/doi.org\/10.1210\/jc.2013-4305","journal-title":"J Clin Endocrinol Metab"},{"key":"1726_CR33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ando.2014.11.004","volume":"76","author":"F Castinetti","year":"2015","unstructured":"Castinetti F, Sahnoun M, Albarel F, Morange I, Philippon M, Conte-Devolx B et al (2015) An observational study on adrenal insufficiency in a French tertiary centre: real life versus theory. Ann Endocrinol (Paris) 76:1\u20138. https:\/\/doi.org\/10.1016\/j.ando.2014.11.004","journal-title":"Ann Endocrinol (Paris)"},{"key":"1726_CR34","doi-asserted-by":"publisher","first-page":"5814","DOI":"10.1210\/jc.2019-00420","volume":"104","author":"R Hayashi","year":"2019","unstructured":"Hayashi R, Tamada D, Murata M, Kitamura T, Mukai K, Maeda N et al (2019) Glucocorticoid replacement affects serum adiponectin levels and HDL-C in patients with secondary adrenal insufficiency. J Clin Endocrinol Metab 104:5814\u20135822. https:\/\/doi.org\/10.1210\/jc.2019-00420","journal-title":"J Clin Endocrinol Metab"},{"key":"1726_CR35","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.2337\/dc26-S002","volume":"49","author":"American Diabetes Association Professional Practice Committee for Diabetes","year":"2026","unstructured":"American Diabetes Association Professional Practice Committee for Diabetes (2026) 2. Diagnosis and classification of diabetes: standards of care in diabetes-2026. Diabetes Care 49:S27. https:\/\/doi.org\/10.2337\/dc26-S002","journal-title":"Diabetes Care"},{"key":"1726_CR36","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1007\/s42000-025-00707-6","volume":"25","author":"F Guerrero-P\u00e9rez","year":"2026","unstructured":"Guerrero-P\u00e9rez F, Iglesias P, Paja Fano M, Moure Rodr\u00edguez MD, Biagetti B, Cordido F et al (2026) Central hypothyroidism and cardiovascular disease: a Spanish cohort observational study. Hormones 25:213\u2013223. https:\/\/doi.org\/10.1007\/s42000-025-00707-6","journal-title":"Hormones"},{"key":"1726_CR37","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s12020-016-1047-x","volume":"54","author":"U Feldt-Rasmussen","year":"2016","unstructured":"Feldt-Rasmussen U, Klose M (2016) Central hypothyroidism and its role for cardiovascular risk factors in hypopituitary patients. Endocr Res 54:15\u201323. https:\/\/doi.org\/10.1007\/s12020-016-1047-x","journal-title":"Endocr Res"},{"key":"1726_CR38","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1210\/jc.2015-1710","volume":"101","author":"SR Bornstein","year":"2016","unstructured":"Bornstein SR, Allolio B, Arlt W, Barthel A, Don-Wauchope A, Hammer GD et al (2016) Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 101:364\u2013389. https:\/\/doi.org\/10.1210\/jc.2015-1710","journal-title":"J Clin Endocrinol Metab"}],"container-title":["Pituitary"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11102-026-01726-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11102-026-01726-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11102-026-01726-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:42:21Z","timestamp":1788457341000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11102-026-01726-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,11]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["1726"],"URL":"https:\/\/doi.org\/10.1007\/s11102-026-01726-1","relation":{},"ISSN":["1386-341X","1573-7403"],"issn-type":[{"value":"1386-341X","type":"print"},{"value":"1573-7403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,11]]},"assertion":[{"value":"14 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"124"}}