Faculty Collaboration Database

High prevalence of frailty in patients with adrenal adenomas and adrenocortical hormone excess: a cross-sectional multi-centre study with prospective enrolment. Eur J Endocrinol 2023 Sep 01;189(3):318-326

Date

08/17/2023

Pubmed ID

37590964

Pubmed Central ID

PMC10479159

DOI

10.1093/ejendo/lvad113

Scopus ID

2-s2.0-85169846671 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

OBJECTIVE: Frailty, characterized by multi-system decline, increases vulnerability to adverse health outcomes and can be measured using Frailty Index (FI). We aimed to assess the prevalence of frailty in patients with adrenal disorders (based on hormonal sub-type) and examine association between FI and performance-based measures of physical function.

DESIGN: Multi-centre, cross-sectional study (March 2019-August 2022).

METHODS: Adult patients with adrenal disorders (non-functioning adrenal adenomas [NFA], mild autonomous cortisol secretion [MACS], Cushing syndrome [CS], primary aldosteronism [PA]) and referent subjects without adrenal disorders completed a questionnaire encompassing 47 health variables (comorbidities, symptoms, daily living activities). FI was calculated as the average score of all variables and frailty defined as FI ≥ 0.25. Physical function was assessed with hand grip, timed up-and-go test, chair rising test, 6-minute walk test, and gait speed.

RESULTS: Compared to referent subjects (n = 89), patients with adrenal disorders (n = 520) showed increased age, sex, and body mass index-adjusted prevalence of frailty (CS [odds ratio-OR 19.2, 95% confidence interval-CI 6.7-70], MACS [OR 12.5, 95% CI 4.8-42.9], PA [OR 8.4, 95% CI 2.9-30.4], NFA [OR 4.5, 95% CI 1.7-15.9]). Prevalence of frailty was similar to referent subjects when post-dexamethasone cortisol was <28 nmol/L and was higher when post-dexamethasone cortisol was 28-50 nmol/L (OR 4.6, 95% CI 1.7-16.5). FI correlated with all measures of physical function (P < .001).

CONCLUSIONS: Whilst frailty prevalence was highest in patients with adrenocortical hormone excess, even patients with NFA demonstrated an increased prevalence compared to the referent population. Future longitudinal studies are needed to evaluate the impact of various management strategies on frailty.

Author List

Dogra P, Šambula L, Saini J, Thangamuthu K, Athimulam S, Delivanis DA, Baikousi DA, Nathani R, Zhang CD, Genere N, Salman Z, Turcu AF, Ambroziak U, Garcia RG, Achenbach SJ, Atkinson EJ, Singh S, LeBrasseur NK, Kastelan D, Bancos I

Author

Catherine Zhang MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenoma
Adrenocortical Adenoma
Adult
Cross-Sectional Studies
Cushing Syndrome
Dexamethasone
Frailty
Hand Strength
Humans
Hydrocortisone
Prevalence
Prospective Studies