Vnitřní lékařství 5/2021

HLAVNÍ TÉMA Výskyt osteoporózy u pacientov na substitučnej liečbe hypokorticizmu u Addisonovej choroby | 269 / Vnitř Lék 2021; 67(5): 264–269 / VNITŘNÍ LÉKAŘSTVÍ www.casopisvnitrnilekarstvi.cz mi HCT ani s dĺžkou trvania liečby. Potenciálne riziko predstavujú vyššie dávky glukokortikoidnej substitučnej terapie (HCT v dávke >25mg denne) a typická konštelácia steroidov (znížené adrenokortikálne andro- gény DHEA a DHEAS, u žien aj estradiol). Zvýšený pomer RANKL/OPG môže svedčiť pre relatívny nedostatok OPG. Možno tak predpokladať, že pacienti ženského pohlavia majú napriek adekvátnej substitúcii zvýšený kostný obrat, a tým aj relatívne vyššie riziko znižovania BMD. LITERATÚRA 1. Arlt W. The approach to the adult with newly diagnosed adrenal insufficiency. J Clin En- docrinol Metab 2009; 94: 1059–1067. 2. Crown A, Lightman S. Why is the management of glucocorticoid deficiency still contro- versial: a review of the literature. Clin Endocrinol (Oxf ) 2005; 63: 483–492. 3. 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