{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T03:48:53Z","timestamp":1777348133323,"version":"3.51.4"},"reference-count":22,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective.<\/jats:bold>\n                    The study was aimed to assess the effect of hydrocortisone (HC) replacement therapy on bone mineral density (BMD) and bone turnover markers in patients with primary adrenal insufficiency (PAI).\n                  <\/jats:p>\n                  <jats:p>Methods. A cross-sectional study was conducted in 37 PAI patients treated with HC. BMD and selected bone turnover markers (\u03b2-crosslaps and osteocalcin) were measured. A stepwise binary logistic regression model was applied to determine the independent variables associated with low BMD.<\/jats:p>\n                  <jats:p>Results. Osteoporosis was noted in 14.3% and osteopenia in 34.3% of cases. These patients were older (p=0.01) and received higher daily HC dose compared to patients with normal BMD (p=0.01). BMD values in the lumbar spine and the femoral neck were negatively correlated with daily HC dose (r=\u20130.36, p=0.03 and r=\u20130.34, p=0.05, respectively). Plasma osteocalcin was negatively correlated with disease duration (r=\u20130.38, p=0.02) and cumulative HC dose (r=\u20130.43, p&lt;0.01). In multivariate analysis, a daily HC dose \u226512 mg\/m2\/day was independently associated with a higher risk of osteopenia\/osteoporosis [OR (95% CI), 9.0 (1.1\u201374.6); p=0.04].<\/jats:p>\n                  <jats:p>\n                    Conclusions. Impaired bone mineralization in patients with PAI is correlated with HC dose. A daily HC dose \u226512 mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    \/day was associated with an increased risk of osteopenia and osteoporosis in these patients.\n                  <\/jats:p>","DOI":"10.2478\/enr-2022-0022","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T14:02:10Z","timestamp":1657720930000},"page":"209-215","source":"Crossref","is-referenced-by-count":9,"title":["Impact of hydrocortisone replacement on bone mineral density and bone turnover markers in patients with primary adrenal insufficiency"],"prefix":"10.2478","volume":"56","author":[{"given":"Meriem","family":"Yazidi","sequence":"first","affiliation":[{"name":"Department of Endocrinology , University of Tunis El Manar , Faculty of Medicine of Tunis , La Rabta Hospital , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyrine","family":"Danguir","sequence":"additional","affiliation":[{"name":"Department of Endocrinology , University of Tunis El Manar , Faculty of Medicine of Tunis , La Rabta Hospital , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhouha","family":"Maamer","sequence":"additional","affiliation":[{"name":"Department of Biochemistry , University of Tunis El Manar , Faculty of Medicine of Tunis , La Rabta Hospital , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibtissem","family":"Oueslati","sequence":"additional","affiliation":[{"name":"Department of Endocrinology , University of Tunis El Manar , Faculty of Medicine of Tunis , La Rabta Hospital , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karima","family":"Khiari","sequence":"additional","affiliation":[{"name":"Department of Endocrinology , University of Tunis El Manar , Faculty of Medicine of Tunis , Charles Nicolle Hospital , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Elleuch","sequence":"additional","affiliation":[{"name":"Department of Rheumatology , University of Tunis El Manar , Faculty of Medicine of Tunis , La Rabta Hospital , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moncef","family":"Feki","sequence":"additional","affiliation":[{"name":"Department of Biochemistry , University of Tunis El Manar , Faculty of Medicine of Tunis , La Rabta Hospital , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melika","family":"Chihaoui","sequence":"additional","affiliation":[{"name":"Department of Endocrinology , University of Tunis El Manar , Faculty of Medicine of Tunis , La Rabta Hospital , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2022,7,13]]},"reference":[{"key":"2026042722155496685_j_enr-2022-0022_ref_001","doi-asserted-by":"crossref","unstructured":"Arlt W, Rosenthal C, Hahner S, Allolio B. 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