Carmen Aresta1, Davide Soranna2, Luca Giovanelli3, Vittoria Favero3, Chiara Parazzoli3, Luigi Gennari4, Luca Persani3, Alfredo Scillitani5, Lewis S Blevins6, David Brown7, Dan Einhorn8, Rosario Pivonello9, Kevin M Pantalone10, Jens Otto Lunde Jørgensen11, Antonella Zambon12, Iacopo Chiodini13. 1. Department of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, Milan, Italy. 2. Biostatistic Unit, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, Milan, Italy. 3. Department of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, Milan, Italy; Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy. 4. Department of Medicine, Surgery and Neurosciences, University of Siena, Italy. 5. Unit of Endocrinology and Diabetology "Casa Sollievo della Sofferenza" Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, San Giovanni Rotondo (FG), Italy. 6. Department of Neurosurgery, University of California San Francisco, California Center for Pituitary Disorders, San Francisco, California. 7. Clinical Endocrinology Practice, Rockville, Maryland. 8. Scripps Whittier Diabetes Institute, La Jolla, California. 9. Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Staff of UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy. 10. Department of Endocrinology, Cleveland Clinic, Cleveland, Ohio. 11. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. 12. Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy; Department of Statistics and Quantitative Methods, Università di Milano-Bicocca, Milan, Italy. 13. Department of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, Milan, Italy; Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy. Electronic address: iacopo.chiodini@unimi.it.
Abstract
OBJECTIVE: To investigate whether the available literature helps to identify the characteristics of patients with type 2 diabetes (T2D) more frequently associated with hidden hypercortisolism (HidHyCo). METHODS: A meta-analysis was performed using studies that assessed both the prevalence of HidHyCo in patients with T2D and the characteristics of these patients with and without HidHyCo. The DerSimonian and Laird (DSL) and Hartung-Knapp-Sidik-Jonkman (HKSJ) methods were utilized. RESULTS: Among the 18 available studies, 6 provided the necessary data. The association between HidHyCo and advanced T2D (based on the patients' description given in each study in the presence of microvascular/macrovascular complications or insulin treatment plus hypertension or hypertension treated with 2 or more drugs), hypertension, insulin treatment, and dyslipidemia was reported in 5 (2184 patients), 6 (2283 patients), 3 (1440 patients), and 3 (987 patients) studies, respectively. HidHyCo was associated with advanced T2D as assessed by both the DSL (odds ratio [OR], 3.4; 95% confidence interval [95% CI], 2.12-5.67) and HKSJ (OR, 3.60; 95% CI, 2.03-6.41) methods and with the prevalence of hypertension or insulin treatment as assessed by the DSL method (OR, 1.92; 95% CI, 1.05-3.50 and OR, 2.29; 95% CI, 1.07-4.91, respectively) but not as assessed by the HKSJ method. CONCLUSION: Patients with advanced T2D have a higher prevalence of HidHyCo. These data inform about the selection of patients with T2D for HidHyCo screening.
OBJECTIVE: To investigate whether the available literature helps to identify the characteristics of patients with type 2 diabetes (T2D) more frequently associated with hidden hypercortisolism (HidHyCo). METHODS: A meta-analysis was performed using studies that assessed both the prevalence of HidHyCo in patients with T2D and the characteristics of these patients with and without HidHyCo. The DerSimonian and Laird (DSL) and Hartung-Knapp-Sidik-Jonkman (HKSJ) methods were utilized. RESULTS: Among the 18 available studies, 6 provided the necessary data. The association between HidHyCo and advanced T2D (based on the patients' description given in each study in the presence of microvascular/macrovascular complications or insulin treatment plus hypertension or hypertension treated with 2 or more drugs), hypertension, insulin treatment, and dyslipidemia was reported in 5 (2184 patients), 6 (2283 patients), 3 (1440 patients), and 3 (987 patients) studies, respectively. HidHyCo was associated with advanced T2D as assessed by both the DSL (odds ratio [OR], 3.4; 95% confidence interval [95% CI], 2.12-5.67) and HKSJ (OR, 3.60; 95% CI, 2.03-6.41) methods and with the prevalence of hypertension or insulin treatment as assessed by the DSL method (OR, 1.92; 95% CI, 1.05-3.50 and OR, 2.29; 95% CI, 1.07-4.91, respectively) but not as assessed by the HKSJ method. CONCLUSION: Patients with advanced T2D have a higher prevalence of HidHyCo. These data inform about the selection of patients with T2D for HidHyCo screening.
Authors: Leah T Braun; Frederick Vogel; Stephanie Zopp; Thomas Marchant Seiter; German Rubinstein; Christina M Berr; Heike Künzel; Felix Beuschlein; Martin Reincke Journal: J Clin Endocrinol Metab Date: 2022-08-18 Impact factor: 6.134