Adrenal insufficiency is commonly treated with multiple daily doses of hydrocortisone, while once-daily low-dose prednisolone serves as an alternative glucocorticoid replacement. However, direct clinical comparisons between these regimens remain limited. To address this gap, a study evaluated differences in metabolism and bone turnover among 47 patients receiving hydrocortisone versus prednisolone therapy.
The study found that prednisolone significantly reduced bone turnover compared with hydrocortisone, with lower levels of bone markers including carboxylated osteocalcin (−1.22 ng/mL), undercarboxylated osteocalcin (−1.38 ng/mL), urinary N-terminal telopeptide (−9.34 nmol/mmol), and procollagen type 1 N-terminal propeptide (−13.8 ng/mL). Prednisolone was also associated with greater reductions in weight (−1.87 kg), BMI (−0.522), waist circumference (−2.26 cm), and HbA1c (−0.12%). There…
