Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.

<h4>Background</h4>Patients 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 h...

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Autores principales:	Ian Louis Ross, Ragnhildur Bergthorsdottir, Naomi Levitt, Joel Alex Dave, Desmond Schatz, David Marais, Gudmundur Johannsson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/75e410ffd89f4912b640af610634c80c
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spelling	oai:doaj.org-article:75e410ffd89f4912b640af610634c80c2021-11-18T08:29:26ZCardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.1932-620310.1371/journal.pone.0090768https://doaj.org/article/75e410ffd89f4912b640af610634c80c2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24603607/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Patients 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.<h4>Methods</h4>In 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.<h4>Results</h4>All 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.<h4>Conclusions</h4>South 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.Ian Louis RossRagnhildur BergthorsdottirNaomi LevittJoel Alex DaveDesmond SchatzDavid MaraisGudmundur JohannssonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 6, p e90768 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ian Louis Ross Ragnhildur Bergthorsdottir Naomi Levitt Joel Alex Dave Desmond Schatz David Marais Gudmundur Johannsson Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.
description	<h4>Background</h4>Patients 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.<h4>Methods</h4>In 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.<h4>Results</h4>All 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.<h4>Conclusions</h4>South 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.
format	article
author	Ian Louis Ross Ragnhildur Bergthorsdottir Naomi Levitt Joel Alex Dave Desmond Schatz David Marais Gudmundur Johannsson
author_facet	Ian Louis Ross Ragnhildur Bergthorsdottir Naomi Levitt Joel Alex Dave Desmond Schatz David Marais Gudmundur Johannsson
author_sort	Ian Louis Ross
title	Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.
title_short	Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.
title_full	Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.
title_fullStr	Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.
title_full_unstemmed	Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.
title_sort	cardiovascular risk factors in patients with addison's disease: a comparative study of south african and swedish patients.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/75e410ffd89f4912b640af610634c80c
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Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.

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