Pub Date : 2026-01-21DOI: 10.1016/s2213-8587(25)00302-x
Elisabeth Nowak, Charlotte L Viëtor, Richard A Feelders, Johannes Hofland, Marta Araujo Castro, César Minguéz Ojeda, Eider Pascual-Corrales, Bahaa Salama, Irina Bancos, Rashi Sandooja, Martin Fassnacht, Barbara Altieri, Mario Detomas, Malgorzata Bobrowicz, Urszula Ambroziak, Adrianna Gladka, Roberta Giordano, Fabio Bioletto, Mirko Parasiliti-Caprino, Edelmiro Menéndez Torre, Martin Reincke
<h3>Background</h3>Treatment for patients with bilateral adrenal tumours and cortisol excess is not standardised and poses a therapeutic dilemma. Untreated cortisol excess is associated with cardiometabolic morbidity and mortality, but bilateral adrenalectomy causes adrenal insufficiency and possibly life-threatening adrenal crises. Data on cardiovascular outcomes by treatment modality are scarce. In this study we aimed to evaluate mid-term and long-term clinical and biochemical outcomes in patients with bilateral adrenal tumours and cortisol excess by treatment strategy and diagnosis.<h3>Methods</h3>This retrospective, international cohort study (in 30 centres across 10 countries in Europe plus Singapore and the USA) included patients with bilateral adrenal tumours of 10 mm or larger, post-dexamethasone serum cortisol concentration of 50 nmol/L or higher, and at least 36 months of follow-up, with data collection beween Feb 2, 2024, and Jan 31, 2025. Patients were excluded if they had adrenocorticotropin hormone (ACTH)-dependent cortisol excess, ACTH-dependent nodular adrenal hyperplasia, partial glucocorticoid resistance syndrome, a diagnosis inconsistent with benign adrenocortical lesions, or received systemic oral or intravenous glucocorticoids other than replacement therapy following adrenalectomy. Primary endpoints were all-cause mortality and clinical and biochemical remission rates. Secondary endpoints were the incidence of cardiovascular events, prevalence of vascular and metabolic comorbidities, and incidence of adrenal crises.<h3>Findings</h3>Of 629 patients who were diagnosed between Jan 1, 2000, and Jan 31, 2022, 105 (17%) had Cushing's syndrome and 524 (83%) had mild autonomous cortisol secretion (MACS), median age was 62 years (IQR 54·0–68·0), and 426 (68%) were female. 85 (81%) of 105 patients with Cushing's syndrome underwent surgery, and 384 (73%) of 524 patients with MACS received non-specific symptomatic treatment (ie, never underwent adrenalectomy or received steroidogenesis inhibitors). Over a median follow-up of 6·8 years, biochemical remission was achieved in 46 (45%) of 102 patients with Cushing's syndrome and in 67 (13%) of 517 patients with MACS. In both groups, 7% of patients died (Cushing's syndrome: seven of 105; MACS: 38 of 524) and 12% (13 of 105) of patients with Cushing's syndrome and 16% (82 of 524) of those with MACS had at least one cardiovascular event, without substantial differences across treatments. Smoking emerged as key modifiable mortality and cardiovascular risk factor in all patients, and in patients with MACS who only received non-specific symptomatic therapy, post-dexamethasone cortisol was also associated with increased mortality. Bilateral adrenalectomy led to full biochemical remission, few non-fatal adrenal crises, and improved arterial hypertension. Unilateral adrenalectomy and steroidogenesis inhibitors yielded heterogeneous biochemical outcomes and no substantial comorbidity improvement. Non-
{"title":"Effect of surgical versus conservative management on cardiovascular outcomes in patients with bilateral adrenal tumours and cortisol excess: an international, retrospective cohort study","authors":"Elisabeth Nowak, Charlotte L Viëtor, Richard A Feelders, Johannes Hofland, Marta Araujo Castro, César Minguéz Ojeda, Eider Pascual-Corrales, Bahaa Salama, Irina Bancos, Rashi Sandooja, Martin Fassnacht, Barbara Altieri, Mario Detomas, Malgorzata Bobrowicz, Urszula Ambroziak, Adrianna Gladka, Roberta Giordano, Fabio Bioletto, Mirko Parasiliti-Caprino, Edelmiro Menéndez Torre, Martin Reincke","doi":"10.1016/s2213-8587(25)00302-x","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00302-x","url":null,"abstract":"<h3>Background</h3>Treatment for patients with bilateral adrenal tumours and cortisol excess is not standardised and poses a therapeutic dilemma. Untreated cortisol excess is associated with cardiometabolic morbidity and mortality, but bilateral adrenalectomy causes adrenal insufficiency and possibly life-threatening adrenal crises. Data on cardiovascular outcomes by treatment modality are scarce. In this study we aimed to evaluate mid-term and long-term clinical and biochemical outcomes in patients with bilateral adrenal tumours and cortisol excess by treatment strategy and diagnosis.<h3>Methods</h3>This retrospective, international cohort study (in 30 centres across 10 countries in Europe plus Singapore and the USA) included patients with bilateral adrenal tumours of 10 mm or larger, post-dexamethasone serum cortisol concentration of 50 nmol/L or higher, and at least 36 months of follow-up, with data collection beween Feb 2, 2024, and Jan 31, 2025. Patients were excluded if they had adrenocorticotropin hormone (ACTH)-dependent cortisol excess, ACTH-dependent nodular adrenal hyperplasia, partial glucocorticoid resistance syndrome, a diagnosis inconsistent with benign adrenocortical lesions, or received systemic oral or intravenous glucocorticoids other than replacement therapy following adrenalectomy. Primary endpoints were all-cause mortality and clinical and biochemical remission rates. Secondary endpoints were the incidence of cardiovascular events, prevalence of vascular and metabolic comorbidities, and incidence of adrenal crises.<h3>Findings</h3>Of 629 patients who were diagnosed between Jan 1, 2000, and Jan 31, 2022, 105 (17%) had Cushing's syndrome and 524 (83%) had mild autonomous cortisol secretion (MACS), median age was 62 years (IQR 54·0–68·0), and 426 (68%) were female. 85 (81%) of 105 patients with Cushing's syndrome underwent surgery, and 384 (73%) of 524 patients with MACS received non-specific symptomatic treatment (ie, never underwent adrenalectomy or received steroidogenesis inhibitors). Over a median follow-up of 6·8 years, biochemical remission was achieved in 46 (45%) of 102 patients with Cushing's syndrome and in 67 (13%) of 517 patients with MACS. In both groups, 7% of patients died (Cushing's syndrome: seven of 105; MACS: 38 of 524) and 12% (13 of 105) of patients with Cushing's syndrome and 16% (82 of 524) of those with MACS had at least one cardiovascular event, without substantial differences across treatments. Smoking emerged as key modifiable mortality and cardiovascular risk factor in all patients, and in patients with MACS who only received non-specific symptomatic therapy, post-dexamethasone cortisol was also associated with increased mortality. Bilateral adrenalectomy led to full biochemical remission, few non-fatal adrenal crises, and improved arterial hypertension. Unilateral adrenalectomy and steroidogenesis inhibitors yielded heterogeneous biochemical outcomes and no substantial comorbidity improvement. Non-","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"161 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/s2213-8587(25)00354-7
Quan-Yang Duh, Michelle B Mulder
No Abstract
没有抽象的
{"title":"More liberal use of bilateral adrenalectomy for bilateral adrenal tumours with cortisol excess","authors":"Quan-Yang Duh, Michelle B Mulder","doi":"10.1016/s2213-8587(25)00354-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00354-7","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"14 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1016/s2213-8587(25)00363-8
Lauren M Quinn, Josephine Elliott, Theodora Papanikolaou, Ian Litchfield, Felicity Boardman, Olga Boiko, Matthew Randell, Fatima Zakia, Joanna Garstang, David Shukla, Christine Burt, Georgios Gkoutos, Animesh Acharjee, Colin Dayan, Sian Faustini, Christopher Bentley, Tim Barrett, Alex Richter, Sheila M Greenfield, Renuka P Dias, Parth Narendran
{"title":"Feasibility of general population screening for type 1 diabetes in the UK: the ELSA study","authors":"Lauren M Quinn, Josephine Elliott, Theodora Papanikolaou, Ian Litchfield, Felicity Boardman, Olga Boiko, Matthew Randell, Fatima Zakia, Joanna Garstang, David Shukla, Christine Burt, Georgios Gkoutos, Animesh Acharjee, Colin Dayan, Sian Faustini, Christopher Bentley, Tim Barrett, Alex Richter, Sheila M Greenfield, Renuka P Dias, Parth Narendran","doi":"10.1016/s2213-8587(25)00363-8","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00363-8","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"258 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/s2213-8587(25)00356-0
Sang Gune K Yoo, Felix Teufel, Michaela Theilmann, Yajuan Si, Elhadji A Toure, Krishna Aryal, Till Bärnighausen, Abdul Bait, Marta Barreto, Pascal Bovet, Luisa C C Brant, Sarah Cuschieri, Albertino Damasceno, Farshad Farzadfar, Asher Fawwad, Pascal Geldsetzer, Ian R Hambleton, Corine Houehanou, Christina Howitt, Jutta J⊘rgensen, Jennifer Manne-Goehler
No Abstract
没有抽象的
{"title":"GLP-1 receptor agonists for obesity: eligibility across 99 countries","authors":"Sang Gune K Yoo, Felix Teufel, Michaela Theilmann, Yajuan Si, Elhadji A Toure, Krishna Aryal, Till Bärnighausen, Abdul Bait, Marta Barreto, Pascal Bovet, Luisa C C Brant, Sarah Cuschieri, Albertino Damasceno, Farshad Farzadfar, Asher Fawwad, Pascal Geldsetzer, Ian R Hambleton, Corine Houehanou, Christina Howitt, Jutta J⊘rgensen, Jennifer Manne-Goehler","doi":"10.1016/s2213-8587(25)00356-0","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00356-0","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"84 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/s2213-8587(25)00401-2
Talha Burki
No Abstract
没有抽象的
{"title":"Integrating mental health and non-communicable disease care: from declarations to practice","authors":"Talha Burki","doi":"10.1016/s2213-8587(25)00401-2","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00401-2","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"7 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-22DOI: 10.1016/s2213-8587(25)00403-6
Amylidi-Mohr S, Zennaro G, Schneider S, Raio L, Mosimann B, Surbek D. Continuous glucose monitoring in the management of gestational diabetes in Switzerland (DipGluMo): an open-label, single-centre, randomised, controlled trial. Lancet Diabetes Endocrinol 2025; 13: 591–99—In this Article, the time above range percentage for the SMGB control group in table 4 should have been 2·3%. This correction has been made to the online version as of Dec 22, 2025.
{"title":"Correction to Lancet Diabetes Endocrinol 2025; 13: 591–99","authors":"","doi":"10.1016/s2213-8587(25)00403-6","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00403-6","url":null,"abstract":"<em>Amylidi-Mohr S, Zennaro G, Schneider S, Raio L, Mosimann B, Surbek D. Continuous glucose monitoring in the management of gestational diabetes in Switzerland (DipGluMo): an open-label, single-centre, randomised, controlled trial.</em> Lancet Diabetes Endocrinol <em>2025; <strong>13:</strong> 591–99</em>—In this Article, the time above range percentage for the SMGB control group in table 4 should have been 2·3%. This correction has been made to the online version as of Dec 22, 2025.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"1 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-19DOI: 10.1016/s2213-8587(25)00290-6
Frederick J Raal, Jean Bergeron, Daniel Gaudet, Robert S Rosenson, David R Sullivan, Traci Turner, Robert A Hegele, Christie M Ballantyne, Joshua W Knowles, Nicholas J Leeper, Ira J Goldberg, Rong Zhou, Ma'an Muhsin, Jennifer Hellawell, James Hamilton, Gerald F Watts
{"title":"Zodasiran, an RNAi therapeutic targeting ANGPTL3, for treating patients with homozygous familial hypercholesterolaemia (GATEWAY): an open-label, randomised, phase 2 trial","authors":"Frederick J Raal, Jean Bergeron, Daniel Gaudet, Robert S Rosenson, David R Sullivan, Traci Turner, Robert A Hegele, Christie M Ballantyne, Joshua W Knowles, Nicholas J Leeper, Ira J Goldberg, Rong Zhou, Ma'an Muhsin, Jennifer Hellawell, James Hamilton, Gerald F Watts","doi":"10.1016/s2213-8587(25)00290-6","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00290-6","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"379 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-19DOI: 10.1016/s2213-8587(25)00330-4
Raul D Santos
{"title":"Does siRNA therapy against ANGPTL3 bring new hope in homozygous familial hypercholesterolaemia?","authors":"Raul D Santos","doi":"10.1016/s2213-8587(25)00330-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00330-4","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"80 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：