PMID- 32628749
OWN - NLM
STAT- MEDLINE
DCOM- 20210224
LR  - 20210707
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 105
IP  - 9
DP  - 2020 Sep 1
TI  - Frailty in Patients With Mild Autonomous Cortisol Secretion is Higher Than in 
      Patients with Nonfunctioning Adrenal Tumors.
PG  - e3307-15
LID - dgaa410 [pii]
LID - 10.1210/clinem/dgaa410 [doi]
AB  - CONTEXT: Mild autonomous cortisol secretion (MACS) affects up to 50% of patients 
      with adrenal adenomas. Frailty is a syndrome characterized by the loss of 
      physiological reserves and an increase in vulnerability, and it serves as a 
      marker of declining health. OBJECTIVE: To compare frailty in patients with MACS 
      versus patients with nonfunctioning adrenal tumors (NFAT). DESIGN: Retrospective 
      study, 2003-2018. SETTING: Referral center. PATIENTS: Patients >20 years of age 
      with adrenal adenoma and MACS (1 mg overnight dexamethasone suppression (DST) of 
      1.9-5 microg/dL) and NFAT (DST <1.9 microg/dL). MAIN OUTCOME MEASURE: Frailty index 
      (range 0-1), calculated using a 47-variable deficit model. RESULTS: Patients with 
      MACS (n = 168) demonstrated a higher age-, sex-, and body mass index-adjusted 
      prevalence of hypertension (71% vs 60%), cardiac arrhythmias (50% vs 40%), and 
      chronic kidney disease (25% vs 17%), but a lower prevalence of asthma (5% vs 14%) 
      than patients with NFAT (n = 275). Patients with MACS reported more symptoms of 
      weakness (21% vs 11%), falls (7% vs 2%), and sleep difficulty (26% vs 15%) as 
      compared with NFAT. Age-, sex- and BMI-adjusted frailty index was higher in 
      patients with MACS vs patients with NFAT (0.17 vs 0.15; P = 0.009). Using a 
      frailty index cutoff of 0.25, 24% of patients with MACS were frail, versus 18% of 
      patients with NFAT (P = 0.028). CONCLUSION: Patients with MACS exhibit a greater 
      burden of comorbid conditions, adverse symptoms, and frailty than patients with 
      NFAT. Future prospective studies are needed to further characterize frailty, 
      examine its responsiveness to adrenalectomy, and assess its influence on health 
      outcomes in patients with MACS.
CI  - (c) Endocrine Society 2020. All rights reserved. For permissions, please e-mail: 
      journals.permissions@oup.com.
FAU - Singh, Sumitabh
AU  - Singh S
AD  - Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 
      Rochester, Minnesota.
FAU - Atkinson, Elizabeth J
AU  - Atkinson EJ
AD  - Department of Health Sciences Research, Mayo Clinic College of Medicine, 
      Rochester, Minnesota.
FAU - Achenbach, Sara J
AU  - Achenbach SJ
AD  - Department of Health Sciences Research, Mayo Clinic College of Medicine, 
      Rochester, Minnesota.
FAU - LeBrasseur, Nathan
AU  - LeBrasseur N
AD  - Department of Physical Medicine and Rehabilitation, Mayo Clinic College of 
      Medicine, Rochester, Minnesota.
FAU - Bancos, Irina
AU  - Bancos I
AD  - Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 
      Rochester, Minnesota.
LA  - eng
GR  - K23 DK121888/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Activities of Daily Living
MH  - Adrenal Gland Neoplasms/*epidemiology/metabolism/pathology
MH  - Adrenocortical Adenoma/*epidemiology/metabolism/pathology
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Female
MH  - Frailty/*epidemiology/metabolism
MH  - Humans
MH  - Hydrocortisone/*metabolism
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Young Adult
PMC - PMC7382051
OTO - NOTNLM
OT  - activity of daily living
OT  - adrenal adenoma
OT  - cortisol
OT  - frailty
OT  - functionality
EDAT- 2020/07/07 06:00
MHDA- 2021/02/25 06:00
PMCR- 2021/07/06
CRDT- 2020/07/07 06:00
PHST- 2020/03/23 00:00 [received]
PHST- 2020/06/30 00:00 [accepted]
PHST- 2020/07/07 06:00 [pubmed]
PHST- 2021/02/25 06:00 [medline]
PHST- 2020/07/07 06:00 [entrez]
PHST- 2021/07/06 00:00 [pmc-release]
AID - 5867964 [pii]
AID - dgaa410 [pii]
AID - 10.1210/clinem/dgaa410 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2020 Sep 1;105(9):e3307-15. doi: 10.1210/clinem/dgaa410.