Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia.
J Endocrinol Invest. 2021 Sep;44(9):1935-1945. doi: 10.1007/s40618-021-01509-4. Epub 2021 Feb 2.
Hypercortisolism is associated with a high prevalence of depression and impaired health-related quality of life (QoL). According to the available literature, studies examining the depression risk in patients with adrenal incidentalomas (AI), nonfunctioning and the ones with (possible) autonomous cortisol secretion ((P)ACS) are scarce. The aim of this observational, case-control study was to screen patients with nonfunctioning adrenal incidentalomas (NAI) and the ones with (P)ACS for depression and to assess their QoL.
The total studied group consisted of 92 subjects-26 with NAI, 34 with (P)ACS and 32 age-matched healthy controls (HC). To screen for depression, we used the Beck Depression Inventory-II (BDI-II) and to assess the QoL, we used the Short-Form 36 Health Survey (SF-36).
Patients with (P)ACS had significantly higher BDI-II scores and substantially lower QoL than patients with NAI or HC. Midnight cortisol level was the most significant predictor of BDI-II and SF-36 score. The receiver operating characteristic curve analysis demonstrated that a midnight cortisol value of 86.95 nmol/l had a high sensitivity (82.8%) and high specificity (80%) for detection of mild depression in patients with (P)ACS.
Screening for depression and QoL assessment should become an integral part of clinical evaluation in patients with (P)ACS.
皮质醇过多与抑郁症高发和健康相关生活质量（QoL）受损相关。根据现有文献，研究检查偶发肾上腺瘤（AI）、无功能和（可能）自主皮质醇分泌（（P）ACS）患者中抑郁症风险的研究很少。本观察性病例对照研究旨在筛选无功能偶发肾上腺瘤（NAI）和（P）ACS 患者中的抑郁症，并评估他们的 QoL。
总研究组包括 92 名受试者-26 名患有 NAI，34 名患有（P）ACS，32 名年龄匹配的健康对照组（HC）。为了筛查抑郁症，我们使用贝克抑郁量表 II（BDI-II），为了评估 QoL，我们使用健康调查简表 36 项（SF-36）。
（P）ACS 患者的 BDI-II 评分明显更高，QoL 明显更低，与 NAI 或 HC 患者相比。午夜皮质醇水平是 BDI-II 和 SF-36 评分的最显著预测因素。受试者工作特征曲线分析表明，午夜皮质醇值为 86.95 nmol/l 时，对（P）ACS 患者轻度抑郁症的检测具有高灵敏度（82.8%）和高特异性（80%）。
在（P）ACS 患者中，筛查抑郁症和评估 QoL 应成为临床评估的一个组成部分。
