{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:41:55Z","timestamp":1790800915432,"version":"4.1.0"},"reference-count":25,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Patients with primary adrenal insufficiency (PAI) suffer from a reduced quality of life. However, clinical factors associated with this impairment remain unclear. The aim of this study was to assess the health-related quality of life (HRQoL) and to evaluate the associations with clinical and hormonal parameters in a group of patients with PAI. (2) Methods: The study included 32 patients with autoimmune PAI, who answered the quality of life in Addison\u2019s disease questionnaire (AddiQoL). Clinical data and hormonal measurements were collected from the patients. (3) Results: The total AddiQoL score of males was significantly higher than that of females (p = 0.011). Furthermore, males reached significantly higher scores in each of the four subscales (fatigue\u2014p = 0.013, emotional sphere\u2014p = 0.048, adrenal insufficiency symptoms\u2014p = 0.039, and miscellaneous questions\u2014p = 0.034). There was a negative correlation between HRQoL and gonadotropin levels (FSH and fatigue r = (\u2212)0.38, p = 0.032; FSH and emotional sphere r = (\u2212)0.416, p = 0.018). This study found no significant associations between AddiQoL scores and the presence of autoimmune comorbidities; only fatigue scores were worse in the presence of autoimmune thyroiditis (p = 0.034). The doses of hydrocortisone and fludrocortisone in the replacement therapy were not associated with AddiQoL scores. AddiQoL scores correlated negatively with the age of diagnosis (p = 0.015). (4) Conclusions: Female sex, higher gonadotropins level, and older age at diagnosis were associated with impaired HRQoL in the studied group of patients with PAI.<\/jats:p>","DOI":"10.3390\/jcm12237237","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T08:47:43Z","timestamp":1700642863000},"page":"7237","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Health-Related Quality of Life in Patients with Primary Adrenal Insufficiency"],"prefix":"10.3390","volume":"12","author":[{"given":"Aleksandra","family":"Zdrojowy-We\u0142na","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicja","family":"Sta\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jowita","family":"Halupczok-\u017by\u0142a","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Szcze\u015bniak","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2360-6596","authenticated-orcid":false,"given":"Marek","family":"Bolanowski","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0140-6736(21)00136-7","article-title":"Adrenal insufficiency","volume":"397","author":"Husebye","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4769","DOI":"10.1210\/jc.2019-00602","article-title":"Autoimmune Polyendocrinopathy","volume":"104","author":"Frommer","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1210\/jc.2015-1710","article-title":"Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline","volume":"101","author":"Bornstein","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1530\/EJE-14-0023","article-title":"Psychological morbidity and impaired quality of life in patients with stable treatment for primary adrenal insufficiency: Cross-sectional study and review of the literature","volume":"171","author":"Tiemensma","year":"2014","journal-title":"Eur. J. Endocrinol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/cen.13719","article-title":"Quality of life in patients with adrenal disease: A systematic review","volume":"89","author":"Ho","year":"2018","journal-title":"Clin. Endocrinol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1210\/jc.2002-020769","article-title":"Replacement of dehydroepiandrosterone in adrenal failure: No benefit for subjective health status and sexuality in a 9-month, randomized, parallel group clinical trial","volume":"88","author":"Trovik","year":"2003","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1210\/jc.2007-1134","article-title":"Long-term DHEA replacement in primary adrenal insufficiency: A randomized, controlled trial","volume":"93","author":"Gurnell","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/cen.12484","article-title":"Impaired health-related quality of life in Addison\u2019s disease\u2014Impact of replacement therapy, comorbidities and socio-economic factors","volume":"81","author":"Kluger","year":"2014","journal-title":"Clin. Endocrinol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"718660","DOI":"10.3389\/fendo.2021.718660","article-title":"Sex-Specific Limitations in Physical Health in Primary Adrenal Insufficiency","volume":"12","author":"Didriksen","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1210\/jc.2009-1711","article-title":"Development of a Disease-Specific Quality of Life Questionnaire in Addison\u2019s Disease","volume":"95","author":"Curran","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1210\/jc.2011-1901","article-title":"Quality of life in European patients with Addison\u2019s disease: Validity of the disease-specific questionnaire AddiQoL","volume":"97","author":"Bensing","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1210\/jc.2013-4253","article-title":"Continuous subcutaneous hydrocortisone infusion versus oral hydrocortisone replacement for treatment of Addison\u2019s disease: A randomized clinical trial","volume":"99","author":"Isaksson","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1530\/EJE-14-1114","article-title":"Modified-release hydrocortisone decreases BMI and HbA1c in patients with primary and secondary adrenal insufficiency","volume":"172","author":"Quinkler","year":"2015","journal-title":"Eur. J. Endocrinol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1007\/s12020-015-0681-z","article-title":"Improvement of anthropometric and metabolic parameters, and quality of life following treatment with dual-release hydrocortisone in patients with Addison\u2019s disease","volume":"51","author":"Giordano","year":"2016","journal-title":"Endocrine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1530\/EC-17-0368","article-title":"Dual-release hydrocortisone treatment: Glycometabolic profile and health-related quality of life","volume":"7","author":"Condorelli","year":"2018","journal-title":"Endocr. Connect."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s12020-017-1513-0","article-title":"Longitudinal AddiQoL scores may identify higher risk for adrenal crises in Addison\u2019s disease","volume":"60","author":"Meyer","year":"2018","journal-title":"Endocrine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1055\/s-0032-1331766","article-title":"What affects the quality of life in autoimmune Addison\u2019s disease?","volume":"45","author":"Meyer","year":"2013","journal-title":"Horm. Metab. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/j.1365-2265.2009.03596.x","article-title":"Influence of hydrocortisone dosage scheme on health-related quality of life in patients with adrenal insufficiency","volume":"72","author":"Bleicken","year":"2010","journal-title":"Clin. Endocrinol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4149","DOI":"10.1210\/jc.2014-2433","article-title":"Continuous subcutaneous hydrocortisone infusion therapy in Addison\u2019s disease: A randomized, placebo-controlled clinical trial","volume":"99","author":"Gagliardi","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1056\/NEJM199909303411401","article-title":"Dehydroepiandrosterone replacement in women with adrenal insufficiency","volume":"341","author":"Arlt","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1210\/clinem\/dgac130","article-title":"Should Dehydroepiandrosterone Be Administered to Women?","volume":"107","author":"Wierman","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1210\/clinem\/dgaa862","article-title":"Improved Urinary Cortisol Metabolome in Addison Disease: A Prospective Trial of Dual-Release Hydrocortisone","volume":"106","author":"Espiard","year":"2021","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_23","first-page":"90","article-title":"Emotions and features of temperament in patients with Addison\u2019s disease","volume":"61","year":"2010","journal-title":"Endokrynol. Pol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1046\/j.1365-2265.2002.01466.x","article-title":"Subjective health status in Norwegian patients with Addison\u2019s disease","volume":"56","author":"Loge","year":"2002","journal-title":"Clin. Endocrinol."},{"key":"ref_25","first-page":"4650","article-title":"Improvement in mood and fatigue after dehydroepiandrosterone replacement in Addison\u2019s disease in a randomized, double blind trial","volume":"85","author":"Hunt","year":"2000","journal-title":"J. Clin. Endocrinol. 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