Skip to main content
ENDO 2026 Main banner

Neuroendocrinology and Pituitary

SAT-063 - The Systemic Effects of Hormone Replacement Therapy for Secondary Adrenal Insufficiency in Patients Affected by Hypothalamic-Pituitary Diseases: A Retrospective and Longitudinal Study.

Saturday, June 13, 2026
9:30 AM - 4:30 PM CT
Location: ENDOExpo; Poster Floor
Glucocorticoid replacement therapy overtreatment in secondary adrenal insufficiency (SAI) can result in various long-term side effects.
With the aim of verifying these effects, we conducted a retrospective, observational, longitudinal study at our hypothalamic-pituitary pathology unit on 140 patients who had undergone neurosurgery before 2020 for PitNETs, craniopharyngiomas, Rathke cleft cysts, chordomas and meningiomas. Exclusion criteria encompassed the utilization of corticosteroids for unrelated indications and prior bariatric surgery.
The patients were divided into a group A, consisting of 70 patients with SAI who had been treated with glucocorticoid replacement therapy for at least 3 years, and group B, consisting of 70 patients without SAI. Lipid metabolism, carbohydrate metabolism, body weight and blood pressure were analyzed at baseline, without differences between the two groups, and after 3 years of therapy.
At follow-up, a worsening of glucose metabolism was observed in 45/140 patients, and univariate analysis showed a higher incidence in patients receiving glucocorticoid replacement therapy (64.4%) compared to untreated patients (35.6%) (p=0.019). This result was confirmed by multivariate analysis, which showed an association with glucocorticoid replacement therapy (p=0.014) and with the presence of impaired glucose tolerance (p=0.016) and impaired fasting glucose (p=0.04) at diagnosis. Regarding lipid metabolism, 92/140 patients worsened, of whom 56.5% were on treatment (p=0.033). However, upon multivariate analysis, the only significant data were treatment for dyslipidemia at baseline (p=0.001) and central hypothyroidism (p=0.001). The data on arterial hypertension demonstrated deterioration in 54/140 patients: 30 were on treatment, while the remaining 24 were not (p=0.298). Multivariate analysis showed a statistically significant association with older age at diagnosis (p=0.007) and with hypertension at baseline (p=0.001).
In conclusion, a glucocorticoid replacement therapy that incorporates holistic patient management alongside the replacement of other possibly deficient axes, does not have an impact on the risk of developing hypertension and dyslipidemia. Instead, glucocorticoid replacement therapy resulted associated to worsening of glucose metabolism, particularly in patients already predisposed.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*