Makino J, Ndzengue A, Adekolujo S, Tipu A, Dogar U M, Mezher H, Sivasambu B, Trauber D, Guillaume E, Jaffe E A, Shiferaw-Deribe Z
Department of Medicine, Interfaith Medical Center, Brooklyn, NY 11213, USA.
Exp Clin Endocrinol Diabetes. 2013 Jan;121(1):32-6. doi: 10.1055/s-0032-1330036. Epub 2013 Jan 17.
Despite the low prevalence (0.008%) of adrenal insufficiency (AI) in the general population, this disorder was recently diagnosed in a substantial number of sickle cell disease (SCD) patients at our hospital. The main objective of this study was to assess the prevalence of AI in SCD patients.
All adult patients admitted to the Department of Medicine at Interfaith Medical Center from October 2010 to November 2011 were eligible for this retrospective study. Medical records of adult SCD patients hospitalized for painful crisis and who had undergone cosyntropin testing were reviewed. Adult non-SCD patients hospitalized for painful crisis and who had undergone cosyntropin testing served as controls. The result of the cosyntropin test was the primary outcome. The prevalence of positive cosyntropin tests was compared between the 2 groups by using Student's t-test, and odds ratios.
62 adult SCD patients were enrolled in the study. 15 underwent cosyntropin testing and 12 (19.4%) of these patients were found to have AI. AI was also diagnosed in 1 of 1,340 non-SCD patients. The odds ratio for AI in SCD to non-SCD patients [(12/62)/(1,340)] was 259. The odds ratio for the prevalence of AI in SCD patients in our study (19.4%) vs. the general population (approximately 0.008%) was 2,375.
AI occurred in 19.4% of SCD patients included in this study. These patients thus have a 2,375-fold higher risk of developing AI than the general population, and a 259-fold greater risk of developing AI than do hospitalized non-SCD patients.
尽管肾上腺功能不全（AI）在普通人群中的患病率较低（0.008%），但最近我院有大量镰状细胞病（SCD）患者被诊断出患有这种疾病。本研究的主要目的是评估SCD患者中AI的患病率。
2010年10月至2011年11月入住跨信仰医疗中心内科的所有成年患者均符合本回顾性研究的条件。回顾了因疼痛危象住院并接受促肾上腺皮质激素试验的成年SCD患者的病历。因疼痛危象住院并接受促肾上腺皮质激素试验的成年非SCD患者作为对照。促肾上腺皮质激素试验的结果是主要观察指标。采用学生t检验和比值比比较两组促肾上腺皮质激素试验阳性的患病率。
62例成年SCD患者纳入研究。15例接受了促肾上腺皮质激素试验，其中12例（19.4%）被发现患有AI。1340例非SCD患者中也有1例被诊断为AI。SCD患者与非SCD患者发生AI的比值比[（12/62）/（1340）]为259。本研究中SCD患者AI患病率（19.4%）与普通人群（约0.008%）相比的比值比为2375。
本研究中19.4%的SCD患者发生了AI。因此，这些患者发生AI的风险比普通人群高2375倍，比住院的非SCD患者高259倍。
