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07.05.2021 | Meta-Analysis

Nonfunctional adrenal adenomas and impaired glucose metabolism: a systematic review and meta-analysis

verfasst von: Fani Athanasouli, Georgios Georgiopoulos, Nikos Asonitis, Fotini Petychaki, Akrivi Savelli, Evangelia Panou, Anna Angelousi

Erschienen in: Endocrine | Ausgabe 1/2021

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Abstract

Purpose

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.

Methods

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.

Results

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)].

Conclusions

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.

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Titel: Nonfunctional adrenal adenomas and impaired glucose metabolism: a systematic review and meta-analysis
verfasst von: Fani Athanasouli
Georgios Georgiopoulos
Nikos Asonitis
Fotini Petychaki
Akrivi Savelli
Evangelia Panou
Anna Angelousi
Publikationsdatum: 07.05.2021
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 1/2021
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-021-02741-x

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