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

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dc.contributor.authorRoss, Ian Louisen_ZA
dc.contributor.authorBergthorsdottir, Ragnhilduren_ZA
dc.contributor.authorLevitt, Naomien_ZA
dc.contributor.authorDave, Joel Alexen_ZA
dc.contributor.authorSchatz, Desmonden_ZA
dc.contributor.authorMarais, Daviden_ZA
dc.contributor.authorJohannsson, Gudmunduren_ZA
dc.date.accessioned2015-11-23T12:29:22Z
dc.date.available2015-11-23T12:29:22Z
dc.date.issued2014en_ZA
dc.description.abstractBACKGROUND: 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. METHODS: 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. RESULTS: 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/m 2 , 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. CONCLUSIONS: 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.en_ZA
dc.identifier.apacitationRoss, I. L., Bergthorsdottir, R., Levitt, N., Dave, J. A., Schatz, D., Marais, D., & Johannsson, G. (2014). Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients. <i>PLoS One</i>, http://hdl.handle.net/11427/15298en_ZA
dc.identifier.chicagocitationRoss, Ian Louis, Ragnhildur Bergthorsdottir, Naomi Levitt, Joel Alex Dave, Desmond Schatz, David Marais, and Gudmundur Johannsson "Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients." <i>PLoS One</i> (2014) http://hdl.handle.net/11427/15298en_ZA
dc.identifier.citationRoss, I. L., Bergthorsdottir, R., Levitt, N., Dave, J. A., Schatz, D., Marais, D., & Johannsson, G. (2014). Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients. PloS one, 9(3). doi:10.1371/journal.pone.0090768en_ZA
dc.identifier.ris TY - Journal Article AU - Ross, Ian Louis AU - Bergthorsdottir, Ragnhildur AU - Levitt, Naomi AU - Dave, Joel Alex AU - Schatz, Desmond AU - Marais, David AU - Johannsson, Gudmundur AB - BACKGROUND: 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. METHODS: 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. RESULTS: 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/m 2 , 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. CONCLUSIONS: 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. DA - 2014 DB - OpenUCT DO - 10.1371/journal.pone.0090768 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients TI - Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients UR - http://hdl.handle.net/11427/15298 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15298
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0090768
dc.identifier.vancouvercitationRoss IL, Bergthorsdottir R, Levitt N, Dave JA, Schatz D, Marais D, et al. Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients. PLoS One. 2014; http://hdl.handle.net/11427/15298.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDivision of Endocrinology and Diabetologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2014 Ross et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherAfricansen_ZA
dc.subject.otherHydrocortisoneen_ZA
dc.subject.otherCardiovascular diseasesen_ZA
dc.subject.otherSwedesen_ZA
dc.subject.otherLipidsen_ZA
dc.subject.otherDiabetes mellitusen_ZA
dc.subject.otherLipid profilesen_ZA
dc.subject.otherAdiponectinen_ZA
dc.titleCardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patientsen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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