Carbon monoxide poisoning ups risk of adrenal insufficiency

The risk of adrenal insufficiency is elevated among people exposed to carbon monoxide poisoning (COP), reports a recent study.

Drawing from Taiwan’s Nationwide Poisoning Database, the researchers assessed 21,842 patients who had been exposed to COP between 1999 and 2012, and compared them against a control population recruited at a 1:2 ratio.

Adrenal insufficiency was diagnosed by treating physicians by assessing blood cortisol levels, as well as adrenocorticotropic hormone to determine the level of defect, causes of defects, and associated problems.

Cox proportional hazard regression analysis found that the risk of adrenal insufficiency was 250 percent greater in those exposed to COP (adjusted hazard ratio [HR], 2.5, 95 percent confidence interval [CI], 1.8–3.5). This estimate remained significant and elevated even after adjustment for sex and underlying comorbid confounders, such as liver, thyroid, and mental disorders.

Moreover, the risk of adrenal insufficiency stayed significantly elevated in the COP group even after 1 year (adjusted HR, 2.1, 95 percent CI, 1.4–3.4). Of note, COP patients who developed acute respiratory failure saw an even higher risk of adrenal insufficiency, pointing to a potential dose-response relationship.

Stratified analysis found that the effect of COP poisoning on adrenal insufficiency risk was greater among women (adjusted HR, 3.5, 95 percent CI, 2.1–6.0) and those aged 20–34 (adjusted HR, 5.5, 95 percent CI, 1.5–20.6) and 35–49 (adjusted HR, 4.9, 95 percent CI, 2.3–10.6) years.