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Bannon CAM, Border D, Hanson P, et al. Early Metabolic Benefits of Switching Hydrocortisone to Modified Release Hydrocortisone in Adult Adrenal Insufficiency. Front Endocrinol (Lausanne). 2021;12:641247doi: 10.3389/fendo.2021.641247.
Bannon, C. A. M., Border, D., Hanson, P., Hattersley, J., Weickert, M. O., Grossman, A., Randeva, H. S., & Barber, T. M. (2021). Early Metabolic Benefits of Switching Hydrocortisone to Modified Release Hydrocortisone in Adult Adrenal Insufficiency. Frontiers in endocrinology, 12641247. https://doi.org/10.3389/fendo.2021.641247
Bannon, Christopher A M, et al. "Early Metabolic Benefits of Switching Hydrocortisone to Modified Release Hydrocortisone in Adult Adrenal Insufficiency." Frontiers in endocrinology vol. 12 (2021): 641247. doi: https://doi.org/10.3389/fendo.2021.641247
Bannon CAM, Border D, Hanson P, Hattersley J, Weickert MO, Grossman A, Randeva HS, Barber TM. Early Metabolic Benefits of Switching Hydrocortisone to Modified Release Hydrocortisone in Adult Adrenal Insufficiency. Front Endocrinol (Lausanne). 2021 Mar 11;12:641247. doi: 10.3389/fendo.2021.641247. eCollection 2021. PMID: 33776936; PMCID: PMC7992002.
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Front Endocrinol (Lausanne). 2021 Mar 11;12:641247. doi: 10.3389/fendo.2021.641247. eCollection 2021.

Early Metabolic Benefits of Switching Hydrocortisone to Modified Release Hydrocortisone in Adult Adrenal Insufficiency.

Frontiers in endocrinology

Christopher A M Bannon, Daniel Border, Petra Hanson, John Hattersley, Martin O Weickert, Ashley Grossman, Harpal S Randeva, Thomas M Barber

Affiliations

  1. Warwickshire Institute for the Study of Diabetes Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, United Kingdom.
  2. Warwick Medical School, University of Warwick, Coventry, United Kingdom.
  3. NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.
  4. Faculty of Health & Life Sciences, Centre of Applied Biological & Exercise Sciences, Coventry University, Coventry, United Kingdom.
  5. Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom.
  6. Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom.

PMID: 33776936 PMCID: PMC7992002 DOI: 10.3389/fendo.2021.641247

Abstract

PURPOSE: To compare metabolic effects of modified release hydrocortisone (MR-HC) with standard hydrocortisone (HC) therapies in adults with Adrenal Insufficiency (AI).

METHODS: Adult patients (n = 12) with AI, established on HC therapy, were recruited from Endocrinology clinics at University Hospitals Coventry and Warwickshire (UHCW), UK. Baseline (HC) metabolic assessments included fasting serum HbA1C, lipid and thyroid profiles, accurate measures of body composition (BodPod), and 24-h continuous measures of energy expenditure including Sleeping Metabolic Rate (SMR) using indirect calorimetry within the Human Metabolism Research Unit, UHCW. All participants then switched HC to MR-HC with repeat (MR-HC) metabolic assessments at 3 months. Paired-sample t-tests were used for data comparisons between HC and MR-HC assessments: P-value <0.05 was considered significant.

RESULTS: Following exclusion of 2 participants, analyses were based on 10 participants. Compared with baseline HC data, following 3 months of MR-HC therapy mean fat mass reduced significantly by -3.2 kg (95% CI: -6.0 to -0.4). Mean (SD) baseline HC fat mass vs repeat MR-HC fat mass: 31.9 kg (15.2) vs 28.7 kg (12.8) respectively, P = 0.03. Mean SMR increased significantly by +77 kcal/24 h (95% CI: 10-146). Mean (SD) baseline HC SMR vs repeat MR-HC SMR: 1,517 kcal/24 h (301) vs 1,594 kcal/24 h (344) respectively, P = 0.03. Mean body fat percentage reduced significantly by -3.4% (95% CI: -6.5 to -0.2). Other measures of body composition, energy expenditure, and biochemical analytes were equivalent between HC and MR-HC assessments.

CONCLUSIONS: In adults with AI, switching from standard HC to MR-HC associates with early metabolic benefits of reduced fat mass and increased SMR.

Copyright © 2021 Bannon, Border, Hanson, Hattersley, Weickert, Grossman, Randeva and Barber.

Keywords: adrenal insufficiency; fat mass; hydrocortisone; metabolism; modified-release hydrocortisone

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. This publication presents i

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