Prevalence of hypercortisolism in type 2 diabetes patients: a meta-analysis

Charlotte Steffensen; Alberto Pereira; Olaf M Dekkers; Jens Otto Jorgensen

doi:10.1530/endoabs.37.EP70

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Endocrine Abstracts (2015) 37 EP70 | DOI: 10.1530/endoabs.37.EP70

ECE2015 Eposter Presentations Adrenal cortex (94 abstracts)

Prevalence of hypercortisolism in type 2 diabetes patients: a meta-analysis

Charlotte Steffensen ¹ , Alberto Pereira ² , Olaf M Dekkers ^2, & Jens Otto Jørgensen ¹

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¹Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; ²Department of Endocrinology/Epidemiology, Leiden, The Netherlands; ³Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.

Background: Type 2 diabetes (T2D) and hypercortisolism associated with Cushing’s syndrome (CS) share clinical characteristics such as hypertension, dyslipidaemia, hyperglycaemia, and obesity. Several studies have recorded a relatively high prevalence of hypercortisolism in T2D, which may have therapeutic implications. The aim of this systematic review and meta-analysis was to assess the prevalence of hypercortisolism in T2D patients.

Methods: Original articles assessing the prevalence of endogenous CS in T2D were eligible. A search was performed in SCOPUS, MEDLINE, and EMBASE. Data were pooled in a random effects logistic model.

Results: Fourteen articles were included, with a total of 2827 T2D patients. The reported prevalence of hypercortisolism in T2D ranged between 0 and 12.1%. The pooled prevalence of hypercortisolism in T2D was 3.6% (95% CI 3.0–4.4). The prevalence did not differ between studies of unselected patients and patients selected on the basis of complications such as obesity or poor glycaemic control (P=0.41). Imaging in patients with hypercortisolism (n=102) revealed adrenal tumour(s) and pituitary tumours in 14 and 52% respectively.

Conclusion: Hypercortisolism is a reproducible and relatively frequent finding in T2D. This observation merits continued interest.