Comorbidities in mild autonomous cortisol secretion and the effect of treatment: systematic review and meta-analysis
Authors' conclusion
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.
Study context
- Population
- Patients with adrenal incidentalomas with or without mild autonomous cortisol secretion (MACS); studies searched in seven databases up to July 14, 202230 cross-sectional, 16 cohort studies
- Participants
- 17,156 patients
- Comparison
- MACS vs non-functioning adrenal incidentaloma; adrenalectomy vs conservative management of MACS
- Outcome
- Comorbidity prevalence, MACS vs non-functioning
Methodological detailsrandom-effects meta-analysis
- Random-effects meta-analysis
Pooled result
As reported in the abstract
Further pooled results
| Outcome | HR (CI) | |
|---|---|---|
| All-cause mortality (adjusted for confounders)4 studies, n = 5921 | 1.54 (1.27–1.81) | |
| 0.512Hazard ratio (log scale) |
Improvement after adrenalectomy (9 observational studies, n = 856; 2 randomized trials, n = 107)
- Glucometabolic control improvement, RR
- 7.99 [2.95-21.90]
- Hypertension improvement, RR
- 8.75 [3.99-19.18]
- Dyslipidemia improvement, RR
- 3.24 [1.19-8.82]
- Comparator not stated
Original publication
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