Adrenal insufficiency epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayeesha Kattubadi, M.B.B.S[2] Muhammad Saad, M.B.B.S.[3]
Overview
Adrenal insufficiency is a rare disorder. It may present in patients of all age groups. The incidence of autoimmune adrenalitis is more common in females in the age groups of 30 to 50 compared to males. Whereas, adrenal crisis does not show any female to male predilection. The most common cause of primary adrenal insufficiency in the developed world is autoimmune adrenalitis. Whereas, in the developing world it is Tuberculosis. The most common cause of central adrenal insufficiency is chronic glucocorticoid use.
Epidemiology and Demographics
Incidence
- The incidence of adrenal insufficiency is approximately 0.8 new cases per 100,000 individuals per year individuals in the developed world. [1]
- The incidence of adrenal insufficiency in Europe is approximately 4.4 to 6.2 new cases per 100,000 individuals per year .[2]
Prevalence
- The prevalence of primary adrenal insufficiency is approximately 117 to 221 cases per 1 million in European populations.[3] [4] [5] [6]
- The prevalence of secondary adrenal insufficiency is rare, ranging from 140 to 279 per 1 million individuals .[7] [8] [9]
Case-fatality rate/Mortality rate
- The mortality rate of adrenal crisis is approximately 0.5/100 patients/year. [10]
Age
- Patients of all age groups may develop adrenal insufficiency.
- Primary adrenal insufficiency commonly affects individuals between 20 to 50 years of age.[11]
- Secondary adrenal insufficiency commonly affects individuals in the 60s. [12]
- The incidence of adrenal crisis increase with age greater than 60 years. [13]
Race
- There is no racial predilection to adrenal insufficiency. [14]
Gender
- Females are more commonly affected by adrenal insufficiency than males. The female to male ratio is approximately 2 to 1 for primary adrenal insufficiency. [15]
- Acute adrenal crisis affects males and females equally. [16]
Region
- The highest incidence of adrenal insufficiency has been reported in Iceland.[17]
Developed Countries
Worldwide, the most common cause of primary adrenal insufficiency was Tuberculosis. However, since the 1950s the incidence of autoimmune adrenalitis has been rising. Now, the most common cause of primary adrenal insufficiency in the developed world is autoimmune adrenalitis. [18]
Developing Countries
The most common cause of primary adrenal insufficiency in the developing world is Tuberculosis. [19]
References
- ↑ Melmed, Shlomo (2020). Williams textbook of endocrinology. Philadelphia, PA: Elsevier. ISBN 9780323555968.
- ↑ Elshimy G, Alghoula F, Jeong JM. PMID 29763143. Missing or empty
|title=(help) - ↑ Melmed, Shlomo (2020). Williams textbook of endocrinology. Philadelphia, PA: Elsevier. ISBN 9780323555968.
- ↑ Laureti S, Vecchi L, Santeusanio F, Falorni A (May 1999). "Is the prevalence of Addison's disease underestimated?". J Clin Endocrinol Metab. 84 (5): 1762. doi:10.1210/jcem.84.5.5677-7. PMID 10323417.
- ↑ Erichsen MM, Løvås K, Skinningsrud B, Wolff AB, Undlien DE, Svartberg J, Fougner KJ, Berg TJ, Bollerslev J, Mella B, Carlson JA, Erlich H, Husebye ES (December 2009). "Clinical, immunological, and genetic features of autoimmune primary adrenal insufficiency: observations from a Norwegian registry". J Clin Endocrinol Metab. 94 (12): 4882–90. doi:10.1210/jc.2009-1368. PMID 19858318.
- ↑ Olafsson AS, Sigurjonsdottir HA (January 2016). "INCREASING PREVALENCE OF ADDISON DISEASE: RESULTS FROM A NATIONWIDE STUDY". Endocr Pract. 22 (1): 30–5. doi:10.4158/EP15754.OR. PMID 26437215.
- ↑ "Group 1. Epidemiology of primary and secondary adrenal insufficiency: Prevalence and incidence, acute adrenal insufficiency, long-term morbidity and mortality - ScienceDirect".
- ↑ "Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain - Regal - 2001 - Clinical Endocrinology - Wiley Online Library".
- ↑ Tomlinson JW, Holden N, Hills RK, Wheatley K, Clayton RN, Bates AS, Sheppard MC, Stewart PM (February 2001). "Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group". Lancet. 357 (9254): 425–31. doi:10.1016/s0140-6736(00)04006-x. PMID 11273062.
- ↑ Elshimy G, Alghoula F, Jeong JM. PMID 29763143. Missing or empty
|title=(help) - ↑ Øksnes M, Husebye ES (December 2023). "Approach to the Patient: Diagnosis of Primary Adrenal Insufficiency in Adults". J Clin Endocrinol Metab. 109 (1): 269–278. doi:10.1210/clinem/dgad402. PMC 10735307 Check
|pmc=value (help). PMID 37450570 Check|pmid=value (help). - ↑ Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K, Grossman A, Hershman JM, Hofland HJ, Kaltsas G, Koch C, Kopp P, Korbonits M, McLachlan R, Morley JE, New M, Purnell J, Singer F, Stratakis CA, Trence DL, Wilson DP, Nicolaides NC, Chrousos GP, Charmandari E. PMID 25905309. Missing or empty
|title=(help) - ↑ Elshimy G, Alghoula F, Jeong JM. PMID 29763143. Missing or empty
|title=(help) - ↑ Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K, Grossman A, Hershman JM, Hofland HJ, Kaltsas G, Koch C, Kopp P, Korbonits M, McLachlan R, Morley JE, New M, Purnell J, Singer F, Stratakis CA, Trence DL, Wilson DP, Nicolaides NC, Chrousos GP, Charmandari E. PMID 25905309. Missing or empty
|title=(help) - ↑ Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K, Grossman A, Hershman JM, Hofland HJ, Kaltsas G, Koch C, Kopp P, Korbonits M, McLachlan R, Morley JE, New M, Purnell J, Singer F, Stratakis CA, Trence DL, Wilson DP, Nicolaides NC, Chrousos GP, Charmandari E. PMID 25905309. Missing or empty
|title=(help) - ↑ Elshimy G, Alghoula F, Jeong JM. PMID 29763143. Missing or empty
|title=(help) - ↑ Elshimy G, Alghoula F, Jeong JM. PMID 29763143. Missing or empty
|title=(help) - ↑ Gardner, David (2018). Greenspan's basic & clinical endocrinology. New York, N.Y: McGraw-Hill Education LLC. ISBN 9781259589287.
- ↑ Gardner, David (2018). Greenspan's basic & clinical endocrinology. New York, N.Y: McGraw-Hill Education LLC. ISBN 9781259589287.