Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objective: To assess (1) comorbidities associated with and (2) treatment strategies for patients with adrenal incidentalomas and mild autonomous cortisol secretion (MACS; > 1.8 µg/dL (>50 nmol/L) cortisol level cut-off following the 1 mg dexamethasone suppression test).
Design: Systematic review and meta-analysis.
Methods: Seven databases were searched up to July 14, 2022. Eligible studies were (randomized) trials, cohort studies, and cross-sectional studies assessing comorbidities potentially attributable to cortisol excess or mortality in patients with adrenal incidentaloma with or without MACS or the effects of conservative or surgical management of MACS. Random-effects meta-analysis was performed to estimate pooled proportions (with 95% CIs).
Results: In 30 cross-sectional and 16 cohort studies (n = 17 156 patients in total), patients with MACS had a higher prevalence of diabetes (relative risk [RR] 1.44 [1.23-1.69]), hypertension (RR = 1.24 [1.16-1.32]), and dyslipidemia (RR = 1.23 [1.13-1.34]). All-cause mortality (adjusted for confounders) in patients with MACS, assessed in 4 studies (n = 5921), was increased (hazard ratio [HR] = 1.54 [1.27-1.81]). Nine observational studies (n = 856) and 2 randomized trials (n = 107) suggest an improvement in glucometabolic control (RR = 7.99 [2.95-21.90]), hypertension (RR = 8.75 [3.99-19.18]), and dyslipidemia (RR = 3.24 [1.19-8.82]) following adrenalectomy.
Conclusions: The present systematic review and meta-analysis highlight the relevance of MACS, since both cardiometabolic morbidities and mortality appeared to have increased in patients with MACS compared to patients with non-functioning incidentalomas. However, due to heterogeneous definitions, various outcomes, selective reporting, and missing data, the reported pooled estimates need to be interpreted with caution. The small number of patients in randomized trials prevents any strong conclusion on the causality between MACS and these comorbidities.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ejendo/lvad134 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Incidence and Prevalence of Frontotemporal Dementia: A Systematic Review and Meta-Analysis.
JAMA Neurol
September 2025
Center for Neurodegenerative Diseases and the Aging Brain, University of Bari 'Aldo Moro,' "Pia Fondazione Cardinale G. Panico," Tricase, Lecce, Italy.
Importance: Comprehensive incidence and prevalence rates of frontotemporal dementia are currently not available.
Objective: To estimate the incidence and prevalence of frontotemporal dementia and its clinical variants in the overall population and age subgroups.
Data Sources And Study Selection: We systematically searched PubMed, EMBASE, and Scopus between January 1, 1990, and October 22, 2024, for population-based studies estimating the incidence and/or prevalence of FTD.
Automated Insulin Delivery Systems and Glucose Management in Children and Adolescents With Type 1 Diabetes: A Systematic Review and Meta-Analysis.
JAMA Pediatr
September 2025
Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.
Importance: Youth living with type 1 diabetes (T1D) are increasingly choosing automated insulin delivery (AID) systems to manage their blood glucose. Few systematic reviews meta-analyzing results from randomized clinical trials (RCTs) are available to guide decision-making.
Objective: To study the association of prolonged AID system use in an outpatient setting with measures of glucose management and quality of life in youth with T1D.
Factors influencing the implementation of mealtime interventions in inpatient and aged care settings: A systematic review.
Int J Speech Lang Pathol
September 2025
Grampians Health, Ballarat, Australia.
Purpose: Many mealtime interventions have been developed over the past ten years. The effective implementation of such interventions into clinical practice is crucial to improve the swallowing safety and/or mealtime-related quality of life for people living with dysphagia or at risk of malnutrition. This systematic review summarises and critically appraises the literature on implementation of mealtime interventions in inpatient and aged care settings.
View Article and Find Full Text PDFPreoperative Oral Clonidine Enhances Surgical Field Quality During Endoscopic Sinus Surgery: A Systematic Review and Meta-Analysis With Trial Sequential Analysis.
Int Forum Allergy Rhinol
September 2025
Department of Otolaryngology-Head and Neck Surgery, Al-Jahra Hospital, Al-Jahra, Kuwait.
Background: Various interventions have been proposed to enhance surgical field quality during endoscopic sinus surgery (ESS). This study evaluates whether preoperative oral clonidine enhances surgical field quality during ESS.
Methods: PubMed, Scopus, Web of Science, Embase, and CENTRAL databases were searched.
Donor site healing in follicular unit extraction hair transplantation: current evidence, cellular mechanisms, and future research directions.
Cell Mol Biol (Noisy-le-grand)
September 2025
Arencibia Clinic, San Sebastian, Spain.
Follicular unit extraction (FUE) has become a leading technique in hair transplantation, yet optimal management of the donor area remains a clinical challenge. This systematic review analyzes intraoperative and postoperative interventions applied to the donor area in FUE hair transplantation, with a focus on both clinical outcomes and the cellular and molecular mechanisms involved in tissue repair, inflammatory response, and regenerative processes. A comprehensive literature search was conducted in PubMed and EMBASE (January 2000-June 2025), identifying clinical studies that evaluated donor area treatments and reported outcomes related to healing, inflammation, infection, and patient satisfaction.
View Article and Find Full Text PDF