Risk of dementia and psychiatric or sleep disorders after diagnosis of adrenal adenomas: a population-based cohort study.
Risk of dementia and psychiatric or sleep disorders after diagnosis of adrenal adenomas: a population-based cohort study.
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肾上腺腺瘤诊断后痴呆和精神或睡眠障碍的风险：一项基于人群的队列研究。
DOI：
10.1093/ejendo/lvad135
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发表时间：
2023
影响因子：
5.8
通讯作者：
Bancos,Irina
中科院分区：
文献类型：
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作者：
Li,Dingfeng;Singh,Sumitabh;Zhang,CatherineD;Kaur,RavinderJeet;Ebbehoj,Andreas;Atkinson,ElizabethJ;Achenbach,SaraJ;Stricker,NikkiH;Mielke,MichelleM;Rocca,Walter;Bancos,Irina
目的肾上腺腺瘤是临床常见病。迄今为止，关于它们对认知、心理健康和睡眠影响的基于人群的数据还很缺乏。我们的目的是研究肾上腺腺瘤与痴呆、精神或睡眠障碍之间可能存在的联系。设计：基于人群的队列研究，明尼苏达州奥姆斯特德县，1995-2017。方法肾上腺腺瘤患者与无明显激素过量的对照者年龄和性别比例为1:1。结果是痴呆、精神或睡眠障碍的基线和事件诊断，使用ICD代码进行评估。结果1004例肾上腺腺瘤患者中，582例（58%）为女性，诊断时中位年龄为63岁。在基线时，在调整了年龄、性别、教育程度、BMI和吸烟等因素后，与对照患者相比，腺瘤患者出现抑郁（调整优势比，aOR: 1.3, 95% CI, 1.1-1.6）、焦虑（aOR: 1.4, 95% CI, 1.1-1.8）和药物滥用（aOR: 2.4, 95% CI, 1.7-3.4）的几率更高。在中位随访6.8年期间，在调整了年龄、性别、社会经济地位、BMI、吸烟和药物滥用等因素后，患者表现出较高的精神和睡眠障碍风险[校正风险比（95% CI）]：抑郁[1.7(1.3-2.2)]、焦虑[1.4，CI(1.1-1.7)]、失眠[1.4(1.0-1.9)]、睡眠相关呼吸障碍[1.5(1.1-1.9)]、嗜睡[2.1(1.0-4.2)]、睡眠相关运动障碍[1.5(1.0-2.1)]，但没有痴呆。结论腺瘤患者有较高的精神障碍和睡眠障碍发生率，这可能与皮质醇分泌增加有关。
ObjectiveAdrenal adenomas are commonly encountered in clinical practice. To date, population-based data on their impact on cognition, mental health, and sleep are lacking. We aimed to study possible associations between adrenal adenomas and dementia, psychiatric or sleep disorders.DesignPopulation-based cohort study, Olmsted County, MN, 1995-2017.MethodsPatients with adrenal adenoma and absent overt hormone excess were age- and sex-matched 1:1 to a referent person without adrenal adenoma. Outcomes were baseline and incident diagnoses of dementia, psychiatric or sleep disorders, assessed using ICD codes.ResultsOf 1004 patients with adrenal adenomas, 582 (58%) were women, and median age at diagnosis was 63 years. At baseline, and after adjusting for age, sex, education, BMI, and tobacco use, patients with adenoma had higher odds of depression (adjusted odds ratio, aOR: 1.3, 95% CI, 1.1-1.6), anxiety (aOR: 1.4, 95% CI, 1.1-1.8), and substance abuse (aOR: 2.4, 95% CI, 1.7-3.4) compared to referents. During a median follow-up of 6.8 years, and after adjusting for age, sex, socioeconomic status, BMI, tobacco, and substance abuse, patients demonstrated a higher risk of psychiatric and sleep disorders [adjusted hazard ratio (95% CI)]: depression [1.7 (1.3-2.2)], anxiety [1.4, CI (1.1-1.7)], insomnia [1.4 (1.0-1.9)], sleep-related breathing disorders [1.5 (1.1-1.9)], hypersomnias [2.1 (1.0-4.2)], parasomnias [2.1 (1.0-4.2)], and sleep-related movement disorders [1.5 (1.0-2.1)], but not dementia.ConclusionsPatients with adenomas demonstrate a higher incidence of psychiatric and sleep disorders, possibly due to the underlying subtle increase in cortisol secretion.