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Glucocorticoid replacement is associated with hypertriglyceridaemia, elevated glucose and higher non-HDL cholesterol and may diminish the association of HDL cholesterol with the-629C > A CETP promoter polymorphism in GH-receiving hypopituitary patients
- Source :
- Clinical Endocrinology, 69(3), 359-366. Wiley
- Publication Year :
- 2008
- Publisher :
- Wiley, 2008.
-
Abstract
- Objectives The effect of glucocorticoid substitution on the prevalence of metabolic syndrome components (NCEP ATP III criteria) and serum lipid levels was determined in GH-replaced hypopituitary patients. As glucocorticoid replacement is associated with a pronounced decrease in plasma cholesteryl ester transfer protein (CETP) activity, we also tested associations of HDL cholesterol with the -629C > A CETP promoter polymorphism in subjects with and without ACTH deficiency.Design and patients In a university setting, we retrieved protocolized clinical and laboratory data from 165 adult hypopituitary patients, who had received GH for 1 year.Results After adjustment for age, sex and smoking, non-HDL cholesterol (P = 0.05) and triglycerides (P = 0.004) were higher, but HDL cholesterol was not decreased in 117 glucocorticoid (mainly cortisone acetate in two divided doses) receiving subjects compared to 48 ACTH-sufficient subjects. The prevalence of elevated plasma glucose and/or diabetes (P = 0.04) and hypertriglyceridaemia (P = 0.005), but not of other metabolic syndrome components, was higher in glucocorticoid-replaced subjects. HDL cholesterol was higher in -629 A allele carriers compared to -629CC homozygotes in ACTH-sufficient subjects (P = 0.04), but not in glucocorticoid-treated subjects (P = 0.13). Multiple linear regression analysis demonstrated that only in ACTH-sufficient subjects, HDL cholesterol was independently related to this CETP gene variation (P = 0.03).Conclusions In GH- and glucocorticoid-replaced hypopituitary patients, serum non-HDL cholesterol and triglycerides are higher and the prevalence of hyperglycaemia is increased, but HDL cholesterol is not decreased. Conventional glucocorticoid replacement appears to diminish the association of HDL cholesterol with a common CETP gene variation.
- Subjects :
- Blood Glucose
Male
GROWTH-HORMONE-DEFICIENT
Genetic Linkage
Endocrinology, Diabetes and Metabolism
DISEASE
chemistry.chemical_compound
Endocrinology
Genotype
Prevalence
Promoter Regions, Genetic
METABOLIC SYNDROME
Hypertriglyceridemia
Human Growth Hormone
CARDIOVASCULAR RISK
Middle Aged
Cholesterol
DENSITY-LIPOPROTEIN CHOLESTEROL
PREMATURE MORTALITY
Female
lipids (amino acids, peptides, and proteins)
CUSHINGS-SYNDROME
Glucocorticoid
medicine.drug
LIPOLYTIC ENZYMES
Adult
medicine.medical_specialty
Adolescent
Hormone Replacement Therapy
Biology
HEALTHY-MEN
Polymorphism, Single Nucleotide
Hypopituitarism
Young Adult
ESTER TRANSFER PROTEIN
Diabetes mellitus
Internal medicine
medicine
Humans
Allele
Glucocorticoids
Aged
Triglyceride
medicine.disease
Cholesterol Ester Transfer Proteins
chemistry
Metabolic syndrome
Subjects
Details
- Language :
- English
- ISSN :
- 03000664
- Volume :
- 69
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Clinical Endocrinology
- Accession number :
- edsair.doi.dedup.....7478dea016c783818645750c67bdb0c3