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Pérez-Castrillón JL, Dueñas-Laita A, Gómez-Alonso C, Jódar E, Del Pino-Montes J, Brandi ML, Cereto Castro F, Quesada-Gómez JM, Gallego López L, Olmos Martínez JM, Alhambra Expósito MR, Galarraga B, González-Macías J, Neyro JL, Bouillon R, Hernández-Herrero G, Fernández-Hernando N, Chinchilla SP. Long-Term Treatment and Effect of Discontinuation of Calcifediol in Postmenopausal Women with Vitamin D Deficiency: A Randomized Trial. J Bone Miner Res 2023; 38:471-479. [PMID: 36661855 DOI: 10.1002/jbmr.4776] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/22/2022] [Accepted: 01/15/2023] [Indexed: 01/21/2023]
Abstract
Vitamin D plays a major role in bone health and probably also in multiple extraskeletal acute and chronic diseases. Although supplementation with calcifediol, a vitamin D metabolite, has demonstrated efficacy and safety in short-term clinical trials, its effects after long-term monthly administration have been studied less extensively. This report describes the results of a 1-year, phase III-IV, double-blind, randomized, controlled, parallel, multicenter superiority clinical trial to assess the efficacy and safety of monthly calcifediol 0.266 mg versus cholecalciferol 25,000 IU (0.625 mg) in postmenopausal women with vitamin D deficiency (25(OH)D < 20 ng/mL). A total of 303 women were randomized and 298 evaluated. Patients were randomized 1:1:1 to calcifediol 0.266 mg/month for 12 months (Group A1), calcifediol 0.266 mg/month for 4 months followed by placebo for 8 months (Group A2), and cholecalciferol 25,000 IU/month (0.625 mg/month) for 12 months (Group B). By month 4, stable 25(OH)D levels were documented with both calcifediol and cholecalciferol (intention-to-treat population): 26.8 ± 8.5 ng/mL (Group A1) and 23.1 ± 5.4 ng/mL (Group B). By month 12, 25(OH)D levels were 23.9 ± 8.0 ng/mL (Group A1) and 22.4 ± 5.5 ng/mL (Group B). When calcifediol treatment was withdrawn in Group A2, 25(OH)D levels decreased to baseline levels (28.5 ± 8.7 ng/mL at month 4 versus 14.4 ± 6.0 ng/mL at month 12). No relevant treatment-related safety issues were reported in any of the groups. The results confirm that long-term treatment with monthly calcifediol in vitamin D-deficient patients is effective and safe. The withdrawal of treatment leads to a pronounced decrease of 25(OH)D levels. Calcifediol presented a faster onset of action compared to monthly cholecalciferol. Long-term treatment produces stable and sustained 25(OH)D concentrations with no associated safety concerns. © 2023 Faes Farma SA. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- José Luis Pérez-Castrillón
- Department of Internal Medicine, Hospital Universitario Río Hortega, Valladolid, Spain
- School of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - Antonio Dueñas-Laita
- School of Medicine, Universidad de Valladolid, Valladolid, Spain
- Clinical Toxicology Unit, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Carlos Gómez-Alonso
- Bone Metabolism Unit, Hospital Universitario Central de Asturias - ISPA, Oviedo, Spain
| | - Esteban Jódar
- Department of Endocrinology & Clinical Nutrition, Hospital Universitario Quironsalud Madrid, Madrid, Spain
- School of Health Sciences, Universidad Europea, Madrid, Spain
| | - Javier Del Pino-Montes
- School of Medicine, Universidad de Salamanca, Salamanca, Spain
- Department of Rheumatology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Maria Luisa Brandi
- FIRMO Foundation (Fondazione Italiana Ricerca sulle Malattie dell'Osso), Florence, Italy
| | | | - José Manuel Quesada-Gómez
- Physiopathology of Endocrine Vitamin D System Biotechnology and Aging, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Laura Gallego López
- Department of Internal Medicine, Hospital Universitario Virgen Macarena, Seville, Spain
| | - José Manuel Olmos Martínez
- Internal Medicine Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
- School of Medicine, Universidad de Cantabria, Santander, Spain
- Infection and Immunity Area, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - María Rosa Alhambra Expósito
- Physiopathology of Endocrine Vitamin D System Biotechnology and Aging, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Bernat Galarraga
- Department of Rheumatology, Hospital Quirónsalud Bizkaia, Erandio, Spain
- Department of Medicine, University of the Basque Country, Leioa, Spain
| | - Jesús González-Macías
- School of Medicine, Universidad de Cantabria, Santander, Spain
- Infection and Immunity Area, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - José Luis Neyro
- Gynecology and Obstetrics Service, Hospital Universitario Cruces, Barakaldo, Spain
- International Master on Climacteric and Menopause, Universidad de Madrid (UDIMA), Madrid, Spain
| | - Roger Bouillon
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
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García Martín A, Alhambra Expósito MR, Cortés Berdonces M, Jódar Gimeno E, Huguet I, Rozas Moreno P, Varsavsky M, Ávila Rubio V, Muñoz Garach A, Muñoz Torres M. Guía de manejo de las alteraciones del metabolismo mineral y óseo en la gestación y la lactancia. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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García Martín A, Alhambra Expósito MR, Cortés Berdonces M, Jódar Gimeno E, Huguet I, Rozas Moreno P, Varsavsky M, Ávila Rubio V, Muñoz Garach A, Muñoz Torres M. Guide of management of alterations in mineral and bone metabolism during gestation and lactation. ENDOCRINOL DIAB NUTR 2022; 69:530-539. [PMID: 36028449 DOI: 10.1016/j.endien.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 10/24/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To provide practical recommendations for the management of mineral and bone metabolism alterations in pregnancy and lactation. PARTICIPANTS Members of the Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology and Nutrition. METHODS Recommendations were formulated according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. A systematic search was carried out in Medline of the available evidence for each pathology. Papers in English with publication date until 29 February 2020 were included. A methodologist resolved the differences that arose during the process of reviewing the literature and formulating recommendations. The recommendations were discussed and approved by all members of the Working Group. CONCLUSIONS The document establishes practical recommendations based on evidence about the management of mineral and bone metabolism disorders in pregnancy and lactation.
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Affiliation(s)
- Antonia García Martín
- Servicio de Endocrinología y Nutrición, Hospital Universitario Clínico San Cecilio, Granada, Spain; Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Granada, Spain.
| | - María Rosa Alhambra Expósito
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - María Cortés Berdonces
- Departamento de Endocrinología y Nutrición Clínica, Hospital Quirón Salud Madrid y Complejo Hospitalario Ruber Juan Bravo, Quirón Salud, Madrid, Spain; Departamento de Formación Médica, Universidad Europea de Madrid, Madrid, Spain
| | - Esteban Jódar Gimeno
- Departamento de Endocrinología y Nutrición Clínica, Hospital Quirón Salud Madrid y Complejo Hospitalario Ruber Juan Bravo, Quirón Salud, Madrid, Spain; Departamento de Formación Médica, Universidad Europea de Madrid, Madrid, Spain
| | - Isabel Huguet
- Servicio de Endocrinología y Nutrición, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Pedro Rozas Moreno
- Sección de Endocrinología y Nutrición, Hospital General Universitario, Ciudad Real, Spain
| | - Mariela Varsavsky
- Servicio de Endocrinología, Metabolismo y Medicina Nuclear, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Verónica Ávila Rubio
- Servicio de Endocrinología y Nutrición, Hospital Universitario Clínico San Cecilio, Granada, Spain; Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Granada, Spain
| | - Araceli Muñoz Garach
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Manuel Muñoz Torres
- Servicio de Endocrinología y Nutrición, Hospital Universitario Clínico San Cecilio, Granada, Spain; Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Granada, Spain; Departamento de Medicina, Universidad de Granada, Granada, Spain
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Pérez-Castrillón JL, Dueñas-Laita A, Gómez-Alonso C, Bouillon R, Jódar E, Brandi ML, González-Macías J, Quesada-Gómez JM, Olmos Martínez JM, Galarraga B, Del Pino-Montes J, Alhambra Expósito MR, Cereto Castro F, Gallego López L, Hernández-Herrero G, Fernández-Hernando N, Arranz-Gutiérrez P, Chinchilla SP. Reply to Calcifediol Is Not Superior to Cholecalciferol in Improving Vitamin D Status in Postmenopausal Women. J Bone Miner Res 2022; 37:1413-1415. [PMID: 35607257 DOI: 10.1002/jbmr.4612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 11/08/2022]
Affiliation(s)
- José Luis Pérez-Castrillón
- Internal Medicine Department, Hospital Universitario Río Hortega, Valladolid, Spain.,School of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - Antonio Dueñas-Laita
- School of Medicine, Universidad de Valladolid, Valladolid, Spain.,Clinical Toxicology Unit, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Carlos Gómez-Alonso
- Bone Metabolism Unit, Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Roger Bouillon
- Department of Chronic Diseases and Metabolism, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
| | - Esteban Jódar
- Department of Endocrinology & Clinical Nutrition, Hospital Universitario Universitario Quironsalud Madrid, Madrid, Spain.,School of Health Sciences, Universidad Europea, Madrid, Spain
| | - Maria Luisa Brandi
- Dipartimento di Scienze Biomediche, Sperimentali e Cliniche "Mario Serio", Università degli Studi di Firenze, Florence, Italy
| | - Jesús González-Macías
- Instituto de Investigación Marqués de Valdecilla - Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.,School of Medicine, Universidad de Cantabria, Santander, Spain
| | - José Manuel Quesada-Gómez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Hospital Universitario Reina Sofía, Córdoba, Spain
| | - José Manuel Olmos Martínez
- School of Medicine, Universidad de Cantabria, Santander, Spain.,Internal Medicine Department, Hospital Universitario Marqués de Valdecilla-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Bernat Galarraga
- Rheumatology Department, Hospital Quirónsalud Bizkaia, Erandio, Spain
| | | | - María Rosa Alhambra Expósito
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Endocrinology and Nutrition Unit, Hospital Universitario Reina Sofía, Córdoba, Spain
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Pérez-Castrillón JL, Dueñas-Laita A, Brandi ML, Jódar E, Del Pino-Montes J, Quesada-Gómez JM, Cereto Castro F, Gómez-Alonso C, Gallego López L, Olmos Martínez JM, Alhambra Expósito MR, Galarraga B, González-Macías J, Bouillon R, Hernández-Herrero G, Fernández-Hernando N, Arranz-Gutiérrez P, Chinchilla SP. Calcifediol is superior to cholecalciferol in improving vitamin D status in postmenopausal women: a randomized trial. J Bone Miner Res 2021; 36:1967-1978. [PMID: 34101900 PMCID: PMC8597097 DOI: 10.1002/jbmr.4387] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/19/2022]
Abstract
Vitamin D has shown to play a role in multiple diseases due to its skeletal and extraskeletal actions. Furthermore, vitamin D deficiency has become a worldwide health issue. Few supplementation guidelines mention calcifediol treatment, despite being the direct precursor of calcitriol and the biomarker of vitamin D status. This 1-year, phase III-IV, double-blind, randomized, controlled, multicenter clinical trial assessed the efficacy and safety of calcifediol 0.266 mg soft capsules in vitamin D-deficient postmenopausal women, compared to cholecalciferol. Results reported here are from a prespecified interim analysis, for the evaluation of the study's primary endpoint: the percentage of patients with serum 25-hydroxyvitamin D (25(OH)D) levels above 30 ng/ml after 4 months. A total of 303 patients were enrolled, of whom 298 were included in the intention-to-treat (ITT) population. Patients with baseline levels of serum 25(OH)D <20 ng/ml were randomized 1:1:1 to calcifediol 0.266 mg/month for 12 months, calcifediol 0.266 mg/month for 4 months followed by placebo for 8 months, and cholecalciferol 25,000 IU/month for 12 months. At month 4, 35.0% of postmenopausal women treated with calcifediol and 8.2% of those treated with cholecalciferol reached serum 25(OH)D levels above 30 ng/ml (p < 0.0001). The most remarkable difference between both drugs in terms of mean change in serum 25(OH)D levels was observed after the first month of treatment (mean ± standard deviation change = 9.7 ± 6.7 and 5.1 ± 3.5 ng/ml in patients treated with calcifediol and cholecalciferol, respectively). No relevant treatment-related safety issues were reported in any of the groups studied. These results thus confirm that calcifediol is effective, faster, and more potent than cholecalciferol in raising serum 25(OH)D levels and is a valuable option for the treatment of vitamin D deficiency. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- José Luis Pérez-Castrillón
- Internal Medicine Department, Hospital Universitario Río Hortega, Valladolid, Spain.,School of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - Antonio Dueñas-Laita
- School of Medicine, Universidad de Valladolid, Valladolid, Spain.,Clinical Toxicology Unit, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Maria Luisa Brandi
- Dipartimento di Scienze Biomediche, Sperimentali e Cliniche "Mario Serio", Università degli Studi di Firenze, Florence, Italy
| | - Esteban Jódar
- Department of Endocrinology & Clinical Nutrition, Hospital Universitario Universitario Quironsalud Madrid, Madrid, Spain.,School of Health Sciences, Universidad Europea, Madrid, Spain
| | - Javier Del Pino-Montes
- School of Medicine, Universidad de Salamanca, Salamanca, Spain.,Rheumatology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - José Manuel Quesada-Gómez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Hospital Universitario Reina Sofía, Córdoba, Spain
| | | | - Carlos Gómez-Alonso
- Bone Metabolism Unit, Hospital Universitario Central de Asturias - ISPA, Oviedo, Spain
| | | | - José Manuel Olmos Martínez
- Internal Medicine Department, Hospital Universitario Marqués de Valdecilla - IDIVAL, Santander, Spain.,School of Medicine, Universidad de Cantabria, Santander, Spain
| | - María Rosa Alhambra Expósito
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Endocrinology and Nutrition Unit Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Bernat Galarraga
- Rheumatology Department, Hospital Quirónsalud Bizkaia, Erandio, Spain
| | - Jesús González-Macías
- School of Medicine, Universidad de Cantabria, Santander, Spain.,Instituto de Investigación marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Roger Bouillon
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
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García Martín A, Varsavsky M, Cortés Berdonces M, Ávila Rubio V, Alhambra Expósito MR, Novo Rodríguez C, Rozas Moreno P, Romero Muñoz M, Jódar Gimeno E, Rodríguez Ortega P, Muñoz Torres M. Phosphate disorders and clinical management of hypophosphatemia and hyperphosphatemia. ACTA ACUST UNITED AC 2019; 67:205-215. [PMID: 31501071 DOI: 10.1016/j.endinu.2019.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/20/2019] [Accepted: 06/03/2019] [Indexed: 12/13/2022]
Abstract
Serum phosphorus levels range from 2.5 and 4.5mg/dL (0.81-1.45 mmol/L) in adults, with higher levels in childhood, adolescence, and pregnancy. Intracellular phosphate is involved in intermediary metabolism and other essential cell functions, while extracellular phosphate is essential for bone matrix mineralization. Plasma phosphorus levels are maintained within a narrow range by regulation of intestinal absorption, redistribution, and renal tubular absorption of the mineral. Hypophosphatemia and hyperphosphatemia are common clinical situations, although changes are most often mild and oligosymptomatic. However, acute and severe conditions that require specific treatment may occur. In this document, members of the Mineral and Bone Metabolism Working Group of the Spanish Society of Endocrinology and Nutrition review phosphate disorders and provide algorithms for adequate clinical management of hypophosphatemia and hyperphosphatemia.
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Affiliation(s)
- Antonia García Martín
- Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario San Cecilio, Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Granada, España.
| | - Mariela Varsavsky
- Servició de Endocrinología, Metabolismo y Medicina Nuclear, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - María Cortés Berdonces
- Servicio de Endocrinología y Nutrición, Complejo Hospitalario Ruber Juan Bravo, Madrid, España
| | - Verónica Ávila Rubio
- Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario San Cecilio, Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Granada, España
| | - María Rosa Alhambra Expósito
- Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Córdoba, España
| | | | - Pedro Rozas Moreno
- Sección de Endocrinología y Nutrición, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Manuel Romero Muñoz
- Unidad de Endocrinología y Nutrición, Hospital General Universitario Rafael Méndez, Lorca, Murcia, España
| | - Esteban Jódar Gimeno
- Departamento de Endocrinología y Nutrición Clínica, Hospital Universitario Quirón Salud Madrid y Hospital Ruber Juan Bravo, Universidad Europea de Madrid, Madrid, España
| | | | - Manuel Muñoz Torres
- Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario San Cecilio, Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Granada, España; Departamento de Medicina, Universidad de Granada, Granada, España
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Alhambra Expósito MR, Tenorio Jiménez C, Molina Puerta MJ, Manzano García G, Prior Sánchez I, Muñoz Jiménez C, Gálvez Moreno MÁ. [Screening for Cushing's syndrome in obese patients; is it really necessary?]. NUTR HOSP 2014; 29:1020-3. [PMID: 24951980 DOI: 10.3305/nh.2014.29.5.7256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
to be more frequent among patients with metabolic syndrome. Previous studies have suggested to perform a routine screening for CS in obese patients; however, more recent reports only recommend a case-finding approach in patients with uncontrolled diabetes and hypertension, despite appropriate treatment. Objective: The aim of this study was to evaluate the prevalence of unsuspected CS in morbidly obese patients in an outpatient’s clinic. Patients and methods: Retrospective case-note study. We reviewed the medical records of morbidly obese patients referred to our clinic prior to bariatric surgery between january 2001 and december 2011. All patients had a complete medical history including physical examination, and 399 underwent screening for CS as part of our pre-surgical protocol. As screening for autonomous cortisol secretion, we performed an overnight 1 mg Dexamethasone Suppression Test (DST). Serum cortisol < 1.8 μg/dl was the cut-off point for normal suppression. Results: 399 patients (308 female; mean age 41.9 ± 10.5 years; mean BMI 51.5 ± 8.4 kg/m2). In the retrospective analysis, prediabetes and diabetes mellitus were observed in 10.3% and 27.8% respectively. In 21 of 399 patients, screening was considered to be abnormal. Eight of these 21 patients had subsequent normal 24h Urinary Free Cortisol (UFC) levels (150 μg/24h). In 13 of 20 patients, we repeated an overnight 1mg DST, on suspicion of failing to take the dexamethasone correctly. Three patients failed to suppress their cortisol levels, two of them were on carbamazepine, which was considered to be a false positive result. The other patient with abnormal UFC levels was diagnosed with CS (0.26%), whose cause was a pituitary microadenoma. Conclusion: A low proportion of patients with morbid obesity were found to have CS. Our findings suggest that morbidly obese patients should not be routinely screened for CS.
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Alhambra Expósito MR, Gálvez Moreno MÁ, Moreno Moreno P, Prior Sánchez I, Muñoz Jiménez C, Benito López P. Evaluación de la efectividad del tratamiento con glucocorticoides intravenosos en la oftalmopatía de Graves. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.endonu.2012.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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