Premature mortality in patients with Addison's disease: A population-based study

被引:389
作者
Bergthorsdottir, Ragnhildur
Leonsson-Zachrisson, Maria
Oden, Anders
Johannsson, Gudmundur
机构
[1] Sahlgrens Univ Hosp, Dept Endocrinol, SE-41345 Gothenburg, Sweden
[2] Chalmers, Dept Math Sci, SE-41296 Gothenburg, Sweden
关键词
D O I
10.1210/jc.2006-0076
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The survival rate of patients with primary adrenal insufficiency (Addison's disease) undergoing currently accepted replacement therapy is not known, although well-informed patients are considered to have a normal survival rate. In this study, we evaluated the mortality of patients with Addison's disease in Sweden. Methods: A population-based, retrospective, observational study was performed, using the National Swedish Hospital and Cause of Death Registers, covering the period from 1987-2001. After a diagnosis of Addison's disease, each patient was followed until the end of follow-up or death. Mortality was compared with that of the Swedish background population. Findings: We identified 1675 patients (995 women and 680 men) diagnosed with primary adrenal insufficiency. The average follow-up from initial diagnosis was 6.5 yr. Five hundred seven patients died during the study period compared with an expected 199. The risk ratio for all-cause mortality was 2.19 (confidence interval 1.91-2.51) for men and 2.86 (confidence interval 2.54-3.20) for women. The excess mortality in both men and women was attributed to cardiovascular, malignant, and infectious diseases. Concomitant diabetes mellitus was observed in 12% of the patients, but only contributed to the increased mortality to a minor extent. Interpretation: Compared with the background population, we observed that the risk ratio for death was more than 2-fold higher in patients with Addison's disease. Cardiovascular, malignant, and infectious diseases were responsible for the higher mortality rate.
引用
收藏
页码:4849 / 4853
页数:5
相关论文
共 33 条
[1]  
*2002 SWED NAT BOA, PAT REG 1964 2003
[2]  
*2002 SWED NAT BOA, DODSORSAKER 2002
[3]  
ADDISON T, 1855, CONSITITUTIONAL LOCA
[4]   PREVALENCE AND INCIDENCE OF DIABETES IN A SWEDISH COMMUNITY 1972-1987 [J].
ANDERSSON, DKG ;
SVARDSUDD, K ;
TIBBLIN, G .
DIABETIC MEDICINE, 1991, 8 (05) :428-434
[5]  
Andrews RC, 1999, CLIN SCI, V96, P513, DOI 10.1042/cs0960513
[6]   Adrenal insufficiency [J].
Arlt, W ;
Allolio, B .
LANCET, 2003, 361 (9372) :1881-1893
[7]  
Arlt W, 2003, J CLIN ENDOCR METAB, V88, P4001, DOI 10.1210/jc.2003-030534
[8]   HYPOTHYROIDISM AND ATHEROSCLEROTIC HEART-DISEASE - PATHOGENESIS, MEDICAL-MANAGEMENT, AND THE ROLE OF CORONARY-ARTERY BYPASS-SURGERY [J].
BECKER, C .
ENDOCRINE REVIEWS, 1985, 6 (03) :432-440
[9]   Incidence, prevalence, and mortality at diabetes in a large population -: A report from the Skaraborg Diabetes Registry [J].
Berger, B ;
Stenström, G ;
Sundkvist, G .
DIABETES CARE, 1999, 22 (05) :773-778
[10]   Autoimmune adrenal insufficiency and autoimmune polyendocrine syndromes: Autoantibodies, autoantigens, and their applicability in diagnosis and disease prediction [J].
Betterle, C ;
Dal Pra, C ;
Mantero, F ;
Zanchetta, R .
ENDOCRINE REVIEWS, 2002, 23 (03) :327-364