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results in an adverse metabolic profile in patients with adrenal insufficiency ( 3 ), and increased 24-h cortisol exposure, as seen in stress, is associated with increased risk of metabolic syndrome ( 22 ). Prednisolone has a longer half-life than
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). Patients with PA also display an increased prevalence of metabolic syndrome and diabetes ( 6 , 7 ), osteoporotic fractures ( 8 ), and symptoms of depression with a reduced quality of life ( 9 ). When PA goes undetected, patients miss out on targeted
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). Several studies suggest that the prevalence of persistent comorbidities is correlated with the duration of exposure to cortisol excess ( 7 , 8 ). However, as the signs and symptoms of CS overlap with common diseases such as the metabolic syndrome and
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LC Willenberg HS , Increased prevalence of diabetes mellitus and the metabolic syndrome in patients with primary aldosteronism of the German Conn’s Registry . European Journal of Endocrinology 2015 173 665 – 675 . ( https://doi.org/10.1530/EJE-15
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. Glucocorticoid dosing should be optimised pre-conception as overtreatment with steroids can both suppress the HPG axis and lead to weight gain and metabolic syndrome, further compromising fertility care. The alterations in HPA axis dynamics and physiological