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Related Concept Videos

Adrenal Gland Disorders01:27

Adrenal Gland Disorders

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Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
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Hormones of the Adrenal Glands01:31

Hormones of the Adrenal Glands

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Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
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Anatomy of the Adrenal Glands01:17

Anatomy of the Adrenal Glands

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The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct...
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Psychoneuroimmunology: Diabetes and Cancer01:19

Psychoneuroimmunology: Diabetes and Cancer

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Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...
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Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

534
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
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Related Experiment Video

Updated: Nov 17, 2025

A Novel Method: Super-selective Adrenal Venous Sampling
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Increased Mortality Risk in Patients With Primary and Secondary Adrenal Insufficiency.

Kanchana Ngaosuwan1,2, Desmond G Johnston1, Ian F Godsland1

  • 1Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College, London, UK.

The Journal of Clinical Endocrinology and Metabolism
|February 17, 2021
PubMed
Summary

Patients with adrenal insufficiency face increased mortality, particularly those with primary disease. Cardiovascular disease is the leading cause of death, but infections also pose a significant risk, highlighting the need for early intervention.

Keywords:
Addison’s diseaseHypopituitarismadrenal crisisadrenal failuredeath

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Area of Science:

  • Endocrinology
  • Public Health
  • Epidemiology

Background:

  • Mortality data in patients with adrenal insufficiency is inconsistent.
  • Discrepancies may stem from temporal and geographical variations in patient populations and their reference groups.

Purpose of the Study:

  • To compare mortality risk and causes of death in individuals with adrenal insufficiency against an individually matched reference population.

Main Methods:

  • A retrospective cohort study utilized the UK general practitioner database (CPRD).
  • 6,821 patients with adrenal insufficiency (primary and secondary) were individually matched with 67,564 controls.
  • Outcomes included all-cause and cause-specific mortality, and hospital admissions for adrenal crisis.

Main Results:

  • All-cause mortality was significantly increased in adrenal insufficiency (HR 1.68), with higher risk in primary disease.
  • Cardiovascular disease was the leading cause of death, followed by malignant neoplasms and respiratory disease.
  • Infections contributed to a high proportion of deaths (HR 4.00), and adrenal crisis accounted for 10% of all deaths, with increased rates early in the disease course.

Conclusions:

  • Adrenal insufficiency, especially primary, is associated with increased mortality, even when individually matched.
  • Cardiovascular disease is a major cause of death, but infections also contribute significantly.
  • Early patient education on infection management and adrenal crisis prevention may reduce mortality.