{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:33:53Z","timestamp":1772166833212,"version":"3.50.1"},"reference-count":14,"publisher":"The Endocrine Society","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context:<\/jats:title>\n                    <jats:p>Current treatment guidelines generally suggest using lower and weight-adjusted glucocorticoid replacement doses in patients with insufficiency of the hypothalamic-pituitary-adrenal (HPA) axis. Although data in patients with acromegaly revealed a positive association between glucocorticoid dose and mortality, no comparable results exist in patients with nonfunctioning pituitary adenomas (NFPA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Our objective was to assess whether higher glucocorticoid replacement doses are associated with increased mortality in patients with NFPA and HPA axis insufficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Participants, and Intervention:<\/jats:title>\n                    <jats:p>We included 105 patients receiving glucocorticoid replacement after pituitary surgery due to NFPA and concomitant HPA axis insufficiency. Patients were grouped according weight-adapted and absolute hydrocortisone (HC) replacement doses. Mortality was assessed using Kaplan-Meier methodology as well as multivariable Cox regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>This was a retrospective analysis conducted at a tertiary referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome:<\/jats:title>\n                    <jats:p>We evaluated overall mortality based on HC replacement doses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Average age at inclusion was 58.9 \u00b1 14.8 yr, and mean follow-up was 12.7 \u00b1 9.4 yr. The groups did not differ according to age, follow-up time, pattern of hypopituitarism, and comorbidities. Kaplan-Meier survival probabilities differed significantly when comparing individuals with differing weight-adjusted HC dose (P = 0.001) as well as absolute HC dose (5\u201319, 20\u201329, and \u226530 mg, P = 0.009). Hazard ratios for mortality increased from 1 (0.05\u20130.24 mg\/kg) to 2.62 (0.25\u20130.34 mg\/kg) to 4.56 (\u22650.35 mg\/kg, P for trend = 0.006) and from 1 (5\u201319 mg) to 2.03 (20\u201329 mg) to 4 (\u226530 mg, P for trend = 0.029), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Higher glucocorticoid replacement doses are associated with increased overall mortality in patients with NFPA and insufficiency of HPA axis. This further substantiates the importance of a balanced and adjusted glucocorticoid replacement therapy in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jc.2012-2432","type":"journal-article","created":{"date-parts":[[2012,10,6]],"date-time":"2012-10-06T15:38:15Z","timestamp":1349537895000},"page":"E1938-E1942","source":"Crossref","is-referenced-by-count":79,"title":["Glucocorticoid Replacement and Mortality in Patients with Nonfunctioning Pituitary Adenoma"],"prefix":"10.1210","volume":"97","author":[{"given":"Thomas","family":"Zueger","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Clinical Nutrition (T.Z., P.K., C.H., E.C., C.S.), CH-3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Kirchner","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Clinical Nutrition (T.Z., P.K., C.H., E.C., C.S.), CH-3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Coline","family":"Herren","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Clinical Nutrition (T.Z., P.K., C.H., E.C., C.S.), CH-3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Fischli","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes (S.F.), Kantonsspital Lucerne, CH-6000 Lucerne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Zwahlen","sequence":"additional","affiliation":[{"name":"Inselspital, Bern University Hospital, and Institute of Social and Preventive Medicine (M.Z.), University of Bern, CH-3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuel","family":"Christ","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Clinical Nutrition (T.Z., P.K., C.H., E.C., C.S.), CH-3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Stettler","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Clinical Nutrition (T.Z., P.K., C.H., E.C., C.S.), CH-3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"key":"2020071618503050300_B1","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/0140-6736(90)91812-O","article-title":"Premature mortality due to cardiovascular disease in hypopituitarism.","volume":"336","author":"Ros\u00e9n","year":"1990","journal-title":"Lancet"},{"key":"2020071618503050300_B2","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S0140-6736(00)04006-X","article-title":"Association between premature mortality and hypopituitarism. 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