AUTHOR=Didriksen Nora Møller , Sævik Åse Bjorvatn , Sortland Linn Solveig , Øksnes Marianne , Husebye Eystein Sverre 

TITLE=Sex-Specific Limitations in Physical Health in Primary Adrenal Insufficiency

JOURNAL=Frontiers in Endocrinology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.718660

DOI=10.3389/fendo.2021.718660

ISSN=1664-2392

ABSTRACT=<sec><title>Background</title><p>Patients with primary adrenal insufficiency (PAI) suffer reduced quality of life (QoL), but comparisons with large-scale normative data are scarce. The clinical characteristics associated with reduced QoL are largely unknown.</p></sec><sec><title>Methods</title><p>Cross-sectional data on clinical characteristics and QoL scores from 494 patients were included. QoL was measured using RAND-36 (generic) and AddiQoL (-30 and -8, disease-specific). RAND-36 is reported as subdomain scores as well as physical (PCS) and metal (MCS) summary scores and compared with normative data.</p></sec><sec><title>Results</title><p>Perception of physical role was consistently decreased across age groups in patients with PAI compared with normative data [75 (0-100) <italic>vs.</italic> 100 (50-100), p&lt;0.001]. Men with PAI reported significantly lower scores for social functioning [88 (75-100) <italic>vs.</italic> 100 (75-100), p&lt;0.001], as well as for vitality and physical role. In women, the greatest impairment was seen in physical role [50 (0-100) <italic>vs.</italic> 100 (50-100), p&lt;0.001], followed by social functioning, vitality, physical function, general health, mental health, and emotional role. Overall, better QoL was associated with male sex (AddiQoL-30: 89 ± 13 <italic>vs.</italic> 82 ± 13, p&lt;0.002), younger age (e.g. 20-29 <italic>vs.</italic> 80-89 years: PCS 59 [50-62] <italic>vs.</italic> 46 [37-53], p&lt;0.001), autoimmune etiology [PCS: 53 (45-59) <italic>vs.</italic>. 45 (38-54), p&lt;0.001], and absence of autoimmune comorbidity [PCS: 54 (45-59) <italic>vs.</italic> 50 (43-58), p&lt;0.001]. There were no significant differences in QoL scores between different doses or dosing regimens of glucocorticoid or mineralocorticoid replacement.</p></sec><sec><title>Conclusion</title><p>QoL is reduced in patients with PAI, especially perception of physical role in women and social functioning in men. Among patients with PAI, female sex, higher age, non-autoimmune etiology, and autoimmune comorbidity was associated with lower QoL-scores.</p></sec>