ArticlePloS one2014
Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Dual-release hydrocortisone for treatment of adrenal insufficiency: a systematic review.Endocrine · 2020Pooled it
- Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2016Guideline
- Novel biomarkers to guide glucocorticoid replacement in primary adrenal insufficiency: a proof-of-concept study using copeptin-derived ratios.Journal of endocrinological investigation · 2026Article
- Mpox Infection and Endocrine Health: Bridging the Knowledge Gap.Medicina (Kaunas, Lithuania) · 2025Review
- Adrenal Insufficiency Associated Cardiomyopathy, From Molecule to Clinic: A Comprehensive Review.Health science reports · 2025Article
- Cardiometabolic Aspects of Congenital Adrenal Hyperplasia.Endocrine reviews · 2025Review
- Tissue Glucocorticoid Metabolism in Adrenal Insufficiency: A Prospective Study of Dual-release Hydrocortisone Therapy.The Journal of clinical endocrinology and metabolism · 2023Article
- Glucocorticoid Replacement for Adrenal Insufficiency and the Development of Non-Alcoholic Fatty Liver Disease.Journal of clinical medicine · 2023Article
- Characteristics and Challenges of Primary Adrenal Insufficiency in Africa: A Review of the Literature.International journal of endocrinology · 2022Review
- The use of prednisolone versus dual-release hydrocortisone in the treatment of hypoadrenalism.Endocrine connections · 2021Review
- Patients with adrenal insufficiency have cardiovascular features associated with hypovolemia.Endocrine · 2020Article
- [Cardiovascular and metabolic impact of glucocorticoid substitution therapy in patients with Addison's disease].The Pan African medical journal · 2018Article
- Dual-release hydrocortisone treatment: glycometabolic profile and health-related quality of life.Endocrine connections · 2018Article
- Adrenal insufficiency - recognition and management.Clinical medicine (London, England) · 2017Review
- Increased Cardiovascular Risk in Patients with Adrenal Insufficiency: A Short Review.BioMed research international · 2017Review
- Article
- Steroid replacement in primary adrenal failure does not appear to affect circulating adipokines.Endocrine · 2015Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with Addison's disease (AD) in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD). Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa.
methodsIn a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden) matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP) and adiponectin were studied.
resultsAll patients were Caucasian and the majority were women N = 36 (65.5%). Mean (standard deviation; SD) ages of the Swedish and South African patients were 52.9 (13.0) and 52.6 (14.4) years and BMI 25.3 (3.2) and 25.8 (4.1) kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1) versus 24.3 (8.0) mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR) triglycerides (TG) [1.59 (1.1-2.46) versus 0.96 (0.74-1.6) mmol/l; p<0.001], total cholesterol (TC) [6.02(1.50) versus 5.13 (0.87) mmol/l; p<0.001], LDL-C [4.43 (1.44) versus 2.75 (0.80) mmol/l; p<0.001] and median hs-CRP [2.15 (0.93-5.45) versus 0.99 (0.57-2.10) mg/L; p<0.003] and lower HDL-C [0.80 (0.40) versus 1.86 (0.46) mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus.
conclusionsSouth African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors.
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