OBJECTIVE Frailty, characterized by multi-system decline, increases vulnerability to adverse health outcomes and can be measured using Frailty Index (FI). We aimed to assess the prevalence of frailty in patients with adrenal disorders (based on hormonal sub-type) and examine association between FI and performance-based measures of physical function. DESIGN Multi-centre, cross-sectional study (March 2019-August 2022). METHODS Adult patients with adrenal disorders (non-functioning adrenal adenomas [NFA], mild autonomous cortisol secretion [MACS], Cushing syndrome [CS], primary aldosteronism [PA]) and referent subjects without adrenal disorders completed a questionnaire encompassing 47 health variables (comorbidities, symptoms, daily living activities). FI was calculated as the average score of all variables and frailty defined as FI ≥ 0.25. Physical function was assessed with hand grip, timed up-and-go test, chair rising test, 6-minute walk test, and gait speed. RESULTS Compared to referent subjects (n = 89), patients with adrenal disorders (n = 520) showed increased age, sex, and body mass index-adjusted prevalence of frailty (CS [odds ratio-OR 19.2, 95% confidence interval-CI 6.7-70], MACS [OR 12.5, 95% CI 4.8-42.9], PA [OR 8.4, 95% CI 2.9-30.4], NFA [OR 4.5, 95% CI 1.7-15.9]). Prevalence of frailty was similar to referent subjects when post-dexamethasone cortisol was <28 nmol/L and was higher when post-dexamethasone cortisol was 28-50 nmol/L (OR 4.6, 95% CI 1.7-16.5). FI correlated with all measures of physical function (P < .001). CONCLUSIONS Whilst frailty prevalence was highest in patients with adrenocortical hormone excess, even patients with NFA demonstrated an increased prevalence compared to the referent population. Future longitudinal studies are needed to evaluate the impact of various management strategies on frailty.

中文翻译：

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肾上腺腺瘤和肾上腺皮质激素过量患者虚弱的患病率很高：一项前瞻性入组的横断面多中心研究。

目标 虚弱以多系统衰退为特征，增加了对不良健康结果的脆弱性，可以使用虚弱指数（FI）来衡量。我们的目的是评估肾上腺疾病患者（基于激素亚型）虚弱的患病率，并检查 FI 与基于表现的身体功能测量之间的关联。设计多中心、横断面研究（2019年3月至2022年8月）。方法 患有肾上腺疾病（无功能性肾上腺腺瘤 [NFA]、轻度自主皮质醇分泌 [MACS]、库欣综合征 [CS]、原发性醛固酮增多症 [PA]）的成年患者和无肾上腺疾病的参考受试者完成了包含 47 个健康变量的调查问卷（合并症、症状、日常生活活动）。FI 计算为所有变量的平均分，虚弱定义为 FI ≥ 0.25。通过握力、定时起立测试、椅子上升测试、6 分钟步行测试和步态速度来评估身体功能。结果 与参照受试者 (n = 89) 相比，肾上腺疾病患者 (n = 520) 的年龄、性别和体重指数调整后的衰弱患病率有所增加 (CS [比值比 - OR 19.2，95% 置信区间 - CI) 6.7-70]，MACS [或 12.5，95% CI 4.8-42.9]，PA [或 8.4，95% CI 2.9-30.4]，NFA [或 4.5，95% CI 1.7-15.9]）。当地塞米松后皮质醇<28 nmol/L 时，虚弱发生率与参照受试者相似，而当地塞米松后皮质醇为 28-50 nmol/L 时，虚弱发生率更高（OR 4.6，95% CI 1.7-16.5）。FI 与所有身体机能测量值相关 (P < .001)。结论 虽然肾上腺皮质激素过多的患者虚弱患病率最高，但即使是 NFA 患者，与参考人群相比，虚弱患病率也有所增加。未来需要纵向研究来评估各种管理策略对衰弱的影响。