An Assessment of Bone Mineral Density in Patients with Addison's Disease and Isolated ACTH Deficiency Treated with Glucocorticoid

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  • CHIKADA Naoko
    Department of Medicine, Tokyo Women's Medical University
  • IMAKI Toshihiro
    Department of Medicine, Tokyo Women's Medical University Department of Bioregulation, Institute of Development and Aging Sciences, Nippon Medical School
  • HOTTA Mari
    Health Services Center, National Graduate Institute for Policy Studies
  • SATO Kanji
    Department of Medicine, Tokyo Women's Medical University
  • TAKANO Kazue
    Department of Medicine, Tokyo Women's Medical University

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Glucocorticoid replacement therapy needs to be tailored to individual patient's requirements in order to avoid risk of over or under medication. We measured bone mineral density (BMD) of lumbar spine using dual X-ray absorptiometory in 10 patients with Addison's disease and 5 patients with isolated ACTH deficiency receiving glucocorticoid replacement therapy. We also examined the effect of glucocorticoid replacement on BMD. Decreased %BMD (less than 80% of age-matched controls) was found in 2 female patients who had received hydrocortisone at a dose of 14.8 and 15.4 mg/m2/day. In contrast, no patient receiving a hydrocortisone dose of less than 12.4 mg/m 2/day had decreased %BMD. There was no correlation between %BMD and hydrocortisone dose (mg/m2), duration of therapy, or cumulative hydrocortisone dose when treated with appropriate dose of hydrocortisone (<13.6 mg/m2). There was also no statistically significant difference in %BMD with age. We concluded that long-term glucocorticoid replacement therapy does not induce bone loss in patients with glucocorticoid deficiency unless an excessive dose of hydrocortisone is given.<br>

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  • Endocrine Journal

    Endocrine Journal 51 (3), 355-360, 2004

    一般社団法人 日本内分泌学会

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