title: DIAGNOSIS OF ENDOCRINE DISEASE: Prevalence of hypercortisolism in type 2 diabetes patients: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Type 2 diabetes (T2D) and Cushing's syndrome (CS) share clinical characteristics, and several small studies have recorded a high prevalence of hypercortisolism in T2D, which could have therapeutic implications. We aimed to assess the prevalence of endogenous hypercortisolism in T2D patients.
  
  
  METHODS
  Systematic review and meta-analysis of the literature.
  
  
  METHODS
  A search was performed in SCOPUS, MEDLINE, and EMBASE for original articles assessing the prevalence of endogenous hypercortisolism and CS in T2D. Data were pooled in a random-effect logistic regression model and reported with 95% confidence intervals (95% CI).
  
  
  RESULTS
  Fourteen articles were included, with a total of 2827 T2D patients. The pooled prevalence of hypercortisolism and CS was 3.4% (95% CI: 1.5-5.9) and 1.4% (95 CI: 0.4-2.9) respectively. The prevalence did not differ between studies of unselected patients and patients selected based on the presence of metabolic features such as obesity or poor glycemic control (P = 0.41 from meta-regression). Imaging in patients with hypercortisolism (n = 102) revealed adrenal tumors and pituitary tumors in 52 and 14% respectively.
  
  
  CONCLUSIONS
  Endogenous hypercortisolism is a relatively frequent finding in T2D, which may have therapeutic implications.
authors.affiliation: Department of Endocrinology and Internal MedicineAarhus University Hospital, Aarhus, Denmark charlotte.steffensen@clin.au.dk.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Steffensen
authors.affiliation: Department of MedicineSection Endocrinology, Leiden University Medical Center, Leiden,  The Netherlands.
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Pereira
authors.affiliation: Department of MedicineSection Endocrinology, Leiden University Medical Center, Leiden,  The Netherlands Department of Clinical EpidemiologyAarhus University Hospital, Aarhus, Denmark Department of Clinical EpidemiologyLeiden University Medical Center, Leiden, The Netherlands.
authors.forename: Olaf M
authors.initials: OM
authors.lastname: Dekkers
authors.affiliation: Department of Endocrinology and Internal MedicineAarhus University Hospital, Aarhus, Denmark.
authors.forename: Jens Otto L
authors.initials: JO
authors.lastname: Jørgensen
mesh_terms: D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology*; D004700:Endocrine System Diseases / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015995:Prevalence