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This study investigates the effect of DR-HC compared with C-HC treatment on five health variables: diurnal salivary cortisol\/cortisone, body composition, bone health, glucose metabolism, lipids, and blood pressure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Prospective study of 27 participants (24 men) with secondary adrenal insufficiency with measurements during stable C-HC and 16 weeks after treatment switch to DR-HC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Outcomes<\/jats:title>\n                <jats:p>Diurnal salivary-cortisol\/cortisone, body composition assessed by Dual-Energy X-ray absorptiometry scan, bone status indices (serum type I N-terminal procollagen [PINP], collagen type I cross-linked C-telopeptide [CTX], osteocalcin, receptor activator kappa-B [RANK] ligand, osteoprotegerin, and sclerostin), lipids, haemoglobin A<jats:sub>1c<\/jats:sub> (HbA<jats:sub>1c<\/jats:sub>), and 24-hour blood pressure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>After the switch to DR-HC, the diurnal salivary-cortisol area under the curve (AUC) decreased non-significantly (mean difference: \u221255.9 nmol\/L\/day, <jats:italic>P<\/jats:italic>\u2009=\u20090.06). The salivary-cortisone-AUC was unchanged. Late-evening salivary-cortisol and cortisone were lower (\u22121.6 and \u22121.7\u2009nmol\/L, <jats:italic>P<\/jats:italic>\u2009=\u20090.002 and 0.004). Total and abdominal fat mass (\u22121.5 and \u22120.5\u2009kg, <jats:italic>P<\/jats:italic>\u2009=\u20090.003 and 0.02), HbA<jats:sub>1c<\/jats:sub> (\u22121.2\u2009mmol\/mol, <jats:italic>P<\/jats:italic>\u2009=\u20090.02), and osteocalcin decreased (\u22127.0\u2009\u00b5g\/L, <jats:italic>P<\/jats:italic>\u2009=\u20090.03) whereas sclerostin increased (+41.1\u2009pg\/mL, <jats:italic>P<\/jats:italic>\u2009=\u20090.0001). The remaining bone status indices, lipids, and blood pressure were unchanged.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study suggests that switching to DR-HC leads to lower late-evening cortisol\/cortisone exposure and a more favourable metabolic profile and body composition. In contrast, decreased osteocalcin with increasing sclerostin might indicate a negative impact on bones.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical trial registration<\/jats:title>\n                <jats:p>EudraCT201400203932<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s12020-024-03711-9","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T05:02:11Z","timestamp":1707714131000},"page":"1182-1192","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Dual-release hydrocortisone improves body composition and the glucometabolic profile in patients with secondary adrenal insufficiency"],"prefix":"10.1007","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6945-2035","authenticated-orcid":false,"given":"Nanna Thurmann","family":"J\u00f8rgensen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Brun","family":"Boesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3939-3388","authenticated-orcid":false,"given":"Stina Willemoes","family":"Borresen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5713-2707","authenticated-orcid":false,"given":"Thea","family":"Christoffersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9624-5210","authenticated-orcid":false,"given":"Niklas Rye","family":"J\u00f8rgensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2404-2702","authenticated-orcid":false,"given":"Peter","family":"Plomgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3751-5203","authenticated-orcid":false,"given":"Christina","family":"Christoffersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6001-7440","authenticated-orcid":false,"given":"Torquil","family":"Watt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5903-3355","authenticated-orcid":false,"given":"Ulla","family":"Feldt-Rasmussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6075-0821","authenticated-orcid":false,"given":"Marianne","family":"Klose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,12]]},"reference":[{"key":"3711_CR1","doi-asserted-by":"publisher","unstructured":"D. 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