Nonfunctional adrenal adenomas and impaired glucose metabolism: a systematic review and meta-analysis
| Autor: | Akrivi Savelli, Fotini Petychaki, Fani Athanasouli, Nikos Asonitis, Anna Angelousi, Evangelia Panou, Georgios Georgiopoulos |
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| Rok vydání: | 2020 |
| Předmět: |
Cortisol secretion
Adenoma Blood Glucose medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Subgroup analysis Gastroenterology 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine Diabetes mellitus medicine Humans Prospective Studies Retrospective Studies business.industry Insulin Odds ratio medicine.disease Confidence interval Glucose Diabetes Mellitus Type 2 030220 oncology & carcinogenesis Meta-analysis Dexamethasone suppression test business |
| Zdroj: | Endocrine. 74(1) |
| ISSN: | 1559-0100 |
| Popis: | Evidence on nonfunctioning adrenal incidentaloma’s (NFAI) associated comorbidities and in particular, glucose disorders, is unclear in contrast to adrenal tumors with mild autonomous cortisol secretion. The current systematic review and meta-analysis aimed to assess the burden of impaired glucose metabolism including diabetes mellitus type 2 (T2DM), fasting blood glucose (FBG), and fasting blood insulin (FBI) levels in patients with NFAI and 1-mg overnight dexamethasone suppression test (ODST) ≤ 1.8 μg/dl across published studies. We searched PubMed, Cochrane, and Scopus databases for identifying studies published between 1956 and March 2021. Twenty-five studies met the selection criteria including prospective, retrospective, and case–control studies. Two reviewers independently extracted studies, participants’ characteristics and outcome data in a total pooled sample of 1548 patients. Patients with NFAI had twofold [(odds ratio (OR) (95% confidence interval (CI)): 2.03 (1.39–2.98)] increased odds to present T2DM as well as higher FBG [weighted mean difference (WMD) (95% CI): 3.85 (1.96–5.74)] and homeostasis model assessment (HOMA) [WMD (95% CI): 0.68 (0.23–1.12)] with respect to controls. On the contrary, the WMD of FBI levels did not differ between the two groups. The incidence of T2DM in a subgroup analysis of patients with NFAI without glucose disorders at baseline was 6% [pooled incidence (95% CI): 0.06 (0.04–0.09)]. Patients with NFAI and 1-mg ODST ≤ 1.8 μg/dl presented higher odds of T2DM and higher levels of FBG and HOMA index than healthy controls. |
| Databáze: | OpenAIRE |
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