DIAGNOSIS OF ENDOCRINE DISEASE: Prevalence of hypercortisolism in type 2 diabetes patients: a systematic review and meta-analysis. Issue 6 (December 2016)

• Record Type: Journal Article
• Authors: Steffensen, Charlotte; Pereira, Alberto M; Dekkers, Olaf M; Jørgensen, Jens Otto L
• Is Part Of: European journal of endocrinology. Volume 175:Issue 6(2016)
• Page Start: R247
• Page End: R253
• Publication Date: 2016-12
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1530/EJE-16-0434
• Languages: English
• ISSNs: 0804-4643

Abstract

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.