Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA.
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
J Clin Endocrinol Metab. 2021 Oct 21;106(11):3320-3330. doi: 10.1210/clinem/dgab468.
While adrenal adenomas have been linked with cardiovascular morbidity in convenience samples of patients from specialized referral centers, large-scale population-based data are lacking.
To determine the prevalence and incidence of cardiometabolic disease and assess mortality in a population-based cohort of patients with adrenal adenomas.
Population-based cohort study.
Olmsted County, Minnesota, USA.
Patients diagnosed with adrenal adenomas without overt hormone excess and age- and sex-matched referent subjects without adrenal adenomas.
Prevalence, incidence of cardiometabolic outcomes, mortality.
(Adrenal adenomas were diagnosed in 1004 patients (58% women, median age 63 years) from 1/01/1995 to 12/31/2017. At baseline, patients with adrenal adenomas were more likely to have hypertension [adjusted odds ratio (aOR) 1.96, 95% CI 1.58-2.44], dysglycemia (aOR 1.63, 95% CI 1.33-2.00), peripheral vascular disease (aOR 1.59, 95% CI 1.32-2.06), heart failure (aOR 1.64, 95% CI 1.15-2.33), and myocardial infarction (aOR 1.50, 95% CI 1.02-2.22) compared to referent subjects. During median follow-up of 6.8 years, patients with adrenal adenomas were more likely than referent subjects to develop de novo chronic kidney disease [adjusted hazard ratio (aHR) 1.46, 95% CI 1.14-1.86], cardiac arrhythmia (aHR 1.31, 95% CI 1.08-1.58), peripheral vascular disease (aHR 1.28, 95% CI 1.05-1.55), cardiovascular events (aHR 1.33, 95% CI 1.01-1.73), and venous thromboembolic events (aHR 2.15, 95% CI 1.48-3.13). Adjusted mortality was similar between the 2 groups.
Adrenal adenomas are associated with an increased prevalence and incidence of adverse cardiometabolic outcomes in a population-based cohort.
虽然在来自专门转诊中心的患者的便利样本中，肾上腺腺瘤与心血管发病率有关，但缺乏大规模的基于人群的数据。
确定肾上腺腺瘤患者人群中患心血管代谢疾病的患病率和发生率，并评估死亡率。
基于人群的队列研究。
美国明尼苏达州奥姆斯特德县。
诊断为无明显激素过度分泌的肾上腺腺瘤患者，以及年龄和性别匹配的无肾上腺腺瘤的参照受试者。
患病率、心血管代谢结局的发生率和死亡率。
（2017 年 12 月 31 日，从 1995 年 1 月 1 日至 12 月 31 日，在奥姆斯特德县诊断出 1004 例（58%为女性，中位年龄 63 岁）肾上腺腺瘤患者。基线时，患有肾上腺腺瘤的患者更有可能患有高血压（校正优势比[OR]1.96，95%置信区间[CI]1.58-2.44）、糖代谢异常（OR 1.63，95%CI 1.33-2.00）、外周血管疾病（OR 1.59，95%CI 1.32-2.06）、心力衰竭（OR 1.64，95%CI 1.15-2.33）和心肌梗死（OR 1.50，95%CI 1.02-2.22）与参照受试者相比。在中位数为 6.8 年的随访期间，与参照受试者相比，患有肾上腺腺瘤的患者更有可能新发慢性肾脏病（调整后的风险比[aHR]1.46，95%CI 1.14-1.86）、心律失常（aHR 1.31，95%CI 1.08-1.58）、外周血管疾病（aHR 1.28，95%CI 1.05-1.55）、心血管事件（aHR 1.33，95%CI 1.01-1.73）和静脉血栓栓塞事件（aHR 2.15，95%CI 1.48-3.13）。两组调整后的死亡率相似。
在基于人群的队列中，肾上腺腺瘤与不良心血管代谢结局的患病率和发生率增加有关。
