Evaluating Latent Adrenal Insufficiency in Elderly Patients With Nocturnal Hypoglycemia: A Retrospective Observational Study.

IF 3.7 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Practice Pub Date : 2024-10-24 DOI:10.1016/j.eprac.2024.10.009
Ken Kanazawa, Mai Hijikata, Koichiro Kuwabara
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Abstract

Objective: To evaluate the association between nocturnal hypoglycemia (NH) and latent adrenal insufficiency (LAI) among elderly aged >65 years.

Methods: This propensity-matched, retrospective observational study was conducted in an outpatient setting, assessing 1238 elderly aged >65 years between November 2017 and February 2020. Of them, 430 patients with unassessed LAI were monitored for NH using continuous glucose monitoring with Freestyle Libre Pro. The primary outcome was the combined prevalence of newly diagnosed and suspected LAI in patients with NH.

Results: After propensity score matching, 192 patients were included (96 each in the NH and non-NH group). The overall incidence rate of NH was 28.8% (124/430). The association of NH with newly diagnosed and suspected LAI was significantly higher in the NH group (26.04%, 50/192) than in the non-NH (12.5%, 24/192) (odds ratio: 3.26; 95% confidence interval: 2.59-9.06; P < .001). In the NH, compared with patients without LAI, those with new-diagnosed LAI had a higher incidence of hypoglycemia.

Conclusions: Diagnosing and treating LAI in the elderly with NH may prevent complications, including fatal diseases, and extend their life expectancy.

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评估夜间低血糖老年患者的潜在肾上腺功能不全:回顾性观察研究
目的评估年龄大于 65 岁的老年人夜间低血糖(NH)与潜在肾上腺功能不全(LAI)之间的关联:这项倾向匹配、回顾性观察研究在门诊环境中进行,评估了 2017 年 11 月至 2020 年 2 月期间年龄大于 65 岁的 1238 名老年人。其中,430 名未评估 LAI 的患者使用 Freestyle Libre Pro® 连续血糖监测仪(CGM)接受了 NH 监测。主要结果是NH患者中新诊断和疑似LAI的综合患病率:经过倾向评分匹配,共纳入 192 名患者(NH 组和非 NH 组各 96 名)。NH的总发病率为28.8%(124/430)。在 NH 组(26.04%,50/192)中,NH 与新诊断和疑似 LAI 的关系明显高于非 NH 组(12.5%,24/192)(几率比:3.26;95% 置信区间:2.59-9.06;P <0.001)。在 NH 中,与没有 LAI 的患者相比,新诊断出 LAI 的患者发生低血糖的几率更高 结论:对患有 NH 的老年人进行 LAI 诊断和治疗可预防包括致命疾病在内的并发症,并延长他们的预期寿命。
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来源期刊
Endocrine Practice
Endocrine Practice ENDOCRINOLOGY & METABOLISM-
CiteScore
7.60
自引率
2.40%
发文量
546
审稿时长
41 days
期刊介绍: Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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