Mirzaei Hadis, Patrova Jekaterina, Mannheimer Buster, Lindh Jonatan D, Falhammar Henrik
Department of Endocrinology, Södersjukhuset, Stockholm, Sweden.
Department of Clinical Science ad Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.
Clin Endocrinol (Oxf). 2025 Apr;102(4):371-379. doi: 10.1111/cen.15186. Epub 2024 Dec 25.
To investigate the prevalence and incidence of dementia in patients with non-overtly functional adrenal tumours (NOFATs).
A national retrospective register-based study was conducted on patients diagnosed with NOFAT and controls diagnosed between 2005 and 2019, in Sweden. Individuals diagnosed with overt adrenal hormone excess or previous malignancies were excluded. Sensitivity analyses were performed in subgroups with a combination of gallbladder/biliary tract/pancreatic disease. and acute appendicitis, as well as 3- and 12-months of malignancy-free survival.
Prevalence and incidence of dementia. The secondary outcomes were Alzheimer's disease and vascular dementia.
Among 20,390 cases, 12,120 (59.4%) were women, and the median (IQR) age was 66 (57-73) years. Among the 125,392 controls, 69,994 (55.8%) were women and the median (IQR) age was 66 (57-73) years. Patients with NOFATs had a lower prevalence of dementia compared to controls (odds ratio [OR] 0.58, 95% CI 0.50-0.68, adjusted OR [aOR] 0.47, 95% CI 0.40-0.56). During the follow-up period (median 4.9 years, IQR 2.2-8.2), incidence of dementia was similar in NOFATs and controls (hazard ratio [HR] 1.05, 95% CI 0.97-1.15, adjusted HR [aHR] 1.06, 95% CI 0.97-1.15). Similar results obtained for Alzheimer's dementia (aOR 0.44, 95% CI 0.34-0.57; aHR 0.94, 95% CI 0.80-1.10) and vascular dementia (OR 0.71, 95% CI 0.52-0.94, aOR 0.48, 95% CI 0.35-0.64; HR 1.29, 95% CI 1.08-1.53, aHR 1.13, 95% CI 0.95-1.35) as well as in the sensitivity analyses. Adrenalectomy did not change the results.
NOFAT was not associated with an increased risk of dementia.
研究非明显功能性肾上腺肿瘤(NOFATs)患者痴呆症的患病率和发病率。
在瑞典对2005年至2019年间诊断为NOFAT的患者及对照组进行了一项基于全国性回顾性登记的研究。排除诊断为明显肾上腺激素过多或既往有恶性肿瘤的个体。对合并胆囊/胆道/胰腺疾病、急性阑尾炎以及无恶性肿瘤生存3个月和12个月的亚组进行了敏感性分析。
痴呆症的患病率和发病率。次要结局为阿尔茨海默病和血管性痴呆。
在20390例病例中,12120例(59.4%)为女性,中位(IQR)年龄为66岁(57 - 73岁)。在125392例对照组中,69994例(55.8%)为女性,中位(IQR)年龄为66岁(57 - 73岁)。与对照组相比,NOFATs患者痴呆症的患病率较低(优势比[OR] 0.58,95%可信区间0.50 - 0.68,调整后OR[aOR] 0.47,95%可信区间0.40 - 0.56)。在随访期间(中位4.9年,IQR 2.2 - 8.2),NOFATs患者和对照组痴呆症的发病率相似(风险比[HR] 1.05,95%可信区间0.97 - 1.15,调整后HR[aHR] 1.06,95%可信区间0.97 - 1.15)。阿尔茨海默病痴呆(aOR 0.44,95%可信区间0.34 - 0.57;aHR 0.94,95%可信区间0.80 - 1.10)和血管性痴呆(OR 0.71,95%可信区间0.52 - 0.94,aOR 0.48,95%可信区间0.35 - 0.64;HR 1.29,95%可信区间1.08 - 1.53,aHR 1.13,95%可信区间0.95 - 1.35)以及敏感性分析中也得到了类似结果。肾上腺切除术未改变结果。
NOFAT与痴呆症风险增加无关。