Skip to main content

ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Adrenal Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1510433
This article is part of the Research Topic Comorbidities of adrenal-related endocrine disorders View all articles

Clinical characteristics of adrenal crisis in 371 adult patients with glucocorticoid-induced adrenal insufficiency

Provisionally accepted
Ying Qiu Ying Qiu 1,2Ying Luo Ying Luo 3Xinqian Geng Xinqian Geng 1Yujian Li Yujian Li 1,2Yunhua Feng Yunhua Feng 1Ying Yang Ying Yang 1*
  • 1 The Affiliated Hospital of Yunnan University, Kunming, China
  • 2 Kunming Medical University, Kunming, China
  • 3 Beijing Normal University, Zhuhai, Zhuhai, Guangdong Province, China

The final, formatted version of the article will be published soon.

    Background: Glucocorticoid-induced adrenal insufficiency (GIAI) is a hypothalamic-pituitary-adrenal (HPA) axis dysfunction caused by long-term use of exogenous steroids. Adrenal crisis (AC) is an acute complication of GIAI and one of the reasons for the increased risk of death. This study aims to analyze the clinical characteristics of GIAI patients with AC and explore the related risk factors. Methods: Clinical data of adult GIAI patients treated at our hospital between January 1, 2014, and December 31, 2023 were included. The demographic characteristics, clinical characteristics, laboratory tests and comorbidities of the patients were collected. Univariate and multivariate regression analyses were used to explore the variables related to the occurrence of AC, and prediction models were constructed.Results: 51 patients (13.75%) developed AC during hospitalization. Mortality was significantly higher in patients with AC than in those without AC. Multivariate logistic regression analysis showed that infection, psychiatric symptoms, serum sodium, albumin, neutrophil-lymphocyte ratio (NLR) and eosinophil-lymphocyte ratio (ELR) were independent risk factors for AC. Among the prediction models constructed by machine learning algorithms, logistic regression model had the best prediction effect.This study investigated the clinical characteristics of AC in GIAI patients. NLR and ELR may be effective predictors of AC in GIAI patients, and combined with other clinically significant indicators, an effective prediction model was constructed. Logistic regression model had the best performance in predicting AC in GIAI patients.

    Keywords: Glucocorticoid-induced adrenal insufficiency, Adrenal crisis, Clinical Characteristics, Prediction models, Neutrophil-lymphocyte ratio, Eosinophillymphocyte ratio

    Received: 12 Oct 2024; Accepted: 27 Nov 2024.

    Copyright: © 2024 Qiu, Luo, Geng, Li, Feng and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ying Yang, The Affiliated Hospital of Yunnan University, Kunming, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.