{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:16:20Z","timestamp":1791882980052,"version":"4.3.4"},"reference-count":42,"publisher":"The Endocrine Society","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background: Hypopituitary patients with untreated GH deficiency and patients on inappropriately high doses of glucocorticoid (GC) share certain clinical features.<\/jats:p>\n               <jats:p>Objective: The aim of the study was to examine the influence of GC substitution on clinical characteristics in hypopituitary patients before and after GH replacement therapy.<\/jats:p>\n               <jats:p>Method: A total of 2424 hypopituitary patients within the KIMS (Pfizer International Metabolic Database) were grouped according to ACTH status. Comparisons were performed between subjects on hydrocortisone (HC) (n = 1186), cortisone acetate (CA) (n = 487), and prednisolone\/dexamethasone (n = 52), and ACTH-sufficient patients (AS) (n = 717) before and after 1 yr of GH treatment in terms of body mass index, waist and hip circumference, blood pressure, glucose, glycosylated hemoglobin (HbA1c), serum lipids, IGF-I, and comorbidity. Hydrocortisone equivalent (HCeq) doses were calculated, and measurements were adjusted for sex and age.<\/jats:p>\n               <jats:p>Results: At baseline, the HC group had increased total cholesterol, triglycerides, waist circumference, and HbA1c, and the prednisolone\/dexamethasone group had increased waist\/hip ratio as compared with AS. After HCeq dose adjustment, the HC group retained higher HbA1c than the CA group. GC-treated patients showed a dose-related increase in serum IGF-I, body mass index, triglycerides, low-density lipoprotein cholesterol and total cholesterol levels. Subjects with HCeq doses less than 20 mg\/d (n = 328) at baseline did not differ from AS in metabolic endpoints. The 1-yr metabolic response to GH was similar in all GC groups and dose categories. All new cases of diabetes (n = 12), stroke (n = 8), and myocardial infarction (n = 3) during GH treatment occurred in GC-treated subjects.<\/jats:p>\n               <jats:p>Conclusion: HCeq doses of at least 20 mg\/d in adults with hypopituitarism are associated with an unfavorable metabolic profile. CA replacement may have metabolic advantages compared with other GCs.<\/jats:p>","DOI":"10.1210\/jc.2006-0524","type":"journal-article","created":{"date-parts":[[2006,8,9]],"date-time":"2006-08-09T03:28:27Z","timestamp":1155094107000},"page":"3954-3961","source":"Crossref","is-referenced-by-count":268,"title":["The Impact of Glucocorticoid Replacement Regimens on Metabolic Outcome and Comorbidity in Hypopituitary Patients"],"prefix":"10.1210","volume":"91","author":[{"given":"Helena","family":"Filipsson","sequence":"first","affiliation":[{"name":"Department of Endocrinology (H.F., G.J.), Sahlgrenska Academy at Gothenburg\u2019s University, SE-413 45 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Monson","sequence":"additional","affiliation":[{"name":"St. Bartholomew\u2019s Hospital (J.P.M.), Queen Mary University of London, London EC1A 7BE, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Koltowska-Ha\u0308ggstro\u0308m","sequence":"additional","affiliation":[{"name":"KIGS\/KIMS\/ACROSTUDY Medical Outcomes (M.K.-H., A.M.), Endocrine Care, Pfizer, SE-191 90 Sollentuna, Sweden"},{"name":"Department of Pharmacy (M.K.-H.), Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Mattsson","sequence":"additional","affiliation":[{"name":"KIGS\/KIMS\/ACROSTUDY Medical Outcomes (M.K.-H., A.M.), Endocrine Care, Pfizer, SE-191 90 Sollentuna, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudmundur","family":"Johannsson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology (H.F., G.J.), Sahlgrenska Academy at Gothenburg\u2019s University, SE-413 45 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071613382055000_R1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1159\/000184245","article-title":"Consequences of growth hormone deficiency in adults and the benefits and risks of recombinant human growth hormone treatment. 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