Charlotte Steffensen1, Alberto M Pereira2, Olaf M Dekkers3, Jens Otto L Jørgensen4. 1. Department of Endocrinology and Internal MedicineAarhus University Hospital, Aarhus, Denmark charlotte.steffensen@clin.au.dk. 2. Department of MedicineSection Endocrinology, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of MedicineSection Endocrinology, Leiden University Medical Center, Leiden, The Netherlands Department of Clinical EpidemiologyAarhus University Hospital, Aarhus, Denmark Department of Clinical EpidemiologyLeiden University Medical Center, Leiden, The Netherlands. 4. Department of Endocrinology and Internal MedicineAarhus University Hospital, Aarhus, Denmark.
Abstract
OBJECTIVE: Type 2 diabetes (T2D) and Cushing's syndrome (CS) share clinical characteristics, and several small studies have recorded a high prevalence of hypercortisolism in T2D, which could have therapeutic implications. We aimed to assess the prevalence of endogenous hypercortisolism in T2D patients. DESIGN: Systematic review and meta-analysis of the literature. METHODS: A search was performed in SCOPUS, MEDLINE, and EMBASE for original articles assessing the prevalence of endogenous hypercortisolism and CS in T2D. Data were pooled in a random-effect logistic regression model and reported with 95% confidence intervals (95% CI). RESULTS: Fourteen articles were included, with a total of 2827 T2D patients. The pooled prevalence of hypercortisolism and CS was 3.4% (95% CI: 1.5-5.9) and 1.4% (95 CI: 0.4-2.9) respectively. The prevalence did not differ between studies of unselected patients and patients selected based on the presence of metabolic features such as obesity or poor glycemic control (P = 0.41 from meta-regression). Imaging in patients with hypercortisolism (n = 102) revealed adrenal tumors and pituitary tumors in 52 and 14% respectively. CONCLUSIONS: Endogenous hypercortisolism is a relatively frequent finding in T2D, which may have therapeutic implications.
OBJECTIVE:Type 2 diabetes (T2D) and Cushing's syndrome (CS) share clinical characteristics, and several small studies have recorded a high prevalence of hypercortisolism in T2D, which could have therapeutic implications. We aimed to assess the prevalence of endogenous hypercortisolism in T2D patients. DESIGN: Systematic review and meta-analysis of the literature. METHODS: A search was performed in SCOPUS, MEDLINE, and EMBASE for original articles assessing the prevalence of endogenous hypercortisolism and CS in T2D. Data were pooled in a random-effect logistic regression model and reported with 95% confidence intervals (95% CI). RESULTS: Fourteen articles were included, with a total of 2827 T2D patients. The pooled prevalence of hypercortisolism and CS was 3.4% (95% CI: 1.5-5.9) and 1.4% (95 CI: 0.4-2.9) respectively. The prevalence did not differ between studies of unselected patients and patients selected based on the presence of metabolic features such as obesity or poor glycemic control (P = 0.41 from meta-regression). Imaging in patients with hypercortisolism (n = 102) revealed adrenal tumors and pituitary tumors in 52 and 14% respectively. CONCLUSIONS: Endogenous hypercortisolism is a relatively frequent finding in T2D, which may have therapeutic implications.
Authors: L Giovanelli; C Aresta; V Favero; M Bonomi; B Cangiano; C Eller-Vainicher; G Grassi; V Morelli; F Pugliese; A Falchetti; L Gennari; A Scillitani; L Persani; I Chiodini Journal: J Endocrinol Invest Date: 2021-01-04 Impact factor: 4.256