Adrenal Incidentalomas are Tied to Increased Risk of Diabetes: Findings from a Prospective Study
Adrenal Incidentalomas are Tied to Increased Risk of Diabetes: Findings from a Prospective Study
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DOI：
10.1210/clinem/dgz284
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发表时间：
2020-04-01
影响因子：
5.8
通讯作者：
Terzolo, Massimo
中科院分区：
文献类型：
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作者：
Reimondo, Giuseppe;Castellano, Elena;Terzolo, Massimo
内容：肾上腺偶发瘤的发生率及其与合并症的关系主要是在回顾性研究中评估的，这可能容易产生确定偏倚。目的：这项工作的目的是评估肾上腺偶发瘤的发生率及其相关的合并症。设计：进行了一项前瞻性队列研究。设置：这项研究在一家公立医院的放射科进行。参与者：2017年1月至2018年6月接受腹部计算机断层扫描（CT）的非选定门诊患者。排除已知或疑似肾上腺疾病或恶性肿瘤的患者。暴露：所有腹部CT扫描由经验丰富的放射科医生进行评估。激素检查，包括1毫克地塞米松抑制试验进行患者轴承adrenalincidentalomas.Main结果和措施：肾上腺incidentalomas的频率在腹部CT的adrenalincidentalomas的患者;频率的共病条件，和激素检查患者轴承adrenalincidentalomas.Results：我们招募了601例，其中7.3%的肾上腺肿瘤被发现偶然。患有肾上腺偶发瘤的患者有较高的体重指数（P = 0.009）和腰围（P = 0.004），更常见的糖尿病（P = 0.0038）。在多变量回归分析中，糖尿病与肾上腺偶发瘤显著相关（P = 0.003）。自主皮质醇分泌观察到50%的患者谁没有抑制皮质醇小于50 nmol/L后1 mg dexamethas.Conclusions：肾上腺偶发瘤的频率高于以前报道的。此外，肾上腺偶发瘤与2型糖尿病的风险增加有关。这一发现不存在确定性偏倚，因为肾上腺偶发瘤患者是从与背景人群具有相同糖尿病风险的前瞻性队列中抽取的。
Context: The frequency of adrenal incidentalomas and their association with comorbid conditions have been assessed mostly in retrospective studies that may be prone to ascertainment bias.Objective: The objective of this work is to evaluate the frequency of adrenal incidentalomas and their associated comorbid conditions.Design: A prospective cohort study was conducted.Setting: This study took place at a radiology department at a public hospital.Participants: Unselected outpatients who underwent an abdominal computed tomography (CT) from January 2017 to June 2018. Patients with known or suspected adrenal disease or malignancy were excluded.Exposure: All abdominal CT scans were evaluated by an experienced radiologist. Hormonal workup including a 1-mg dexamethasone suppression test was performed in patients bearing adrenal incidentalomas.Main Outcome and Measure: Frequency of adrenal incidentalomas in abdominal CT of unselected patients; frequency of comorbid conditions, and hormonal workup in patients bearing adrenal incidentalomas.Results: We recruited 601 patients, and in 7.3% of them an adrenal tumor was found serendipitously. The patients bearing an adrenal incidentaloma had higher body mass index (P =.009) and waist circumference (P =.004) and were more frequently diabetic (P =.0038). At multivariable regression analysis, diabetes was significantly associated with the presence of adrenal incidentalomas (P =.003). Autonomous cortisol secretion was observed in 50% of patients who did not suppress cortisol less than 50 nmol/L after 1 mg dexamethasone.Conclusions: The frequency of adrenal incidentalomas is higher than previously reported. Moreover, adrenal incidentalomas are tied to increased risk of type 2 diabetes. This finding is free from ascertainment bias because patients with adrenal incidentalomas were drawn from a prospective cohort with the same risk of diabetes as the background population.