Adrenal incidentaloma: Do patients with apparently nonfunctioning mass or autonomous cortisol secretion have similar or different clinical and metabolic features?

Abstract

Objective Although there is growing evidence associating nonfunctioning adrenal incidentalomas (NFAI) with cardiovascular risk factors, there are limited data whether NFAI and autonomous cortisol secretion (ACS) groups have similar or different clinical and metabolic features. The aim of this study is to compare cardiometabolic clinic parameters among patients with ACS and NFAI, as well as controls. Design Cross‐sectional study. Patients Eighty nine NFAI, 58 ACS and 64 controls were evaluated. Measurements Diagnosis of NFAI (1 mg dexamethasone suppression test [1 mg‐DST] ≤50 nmol/L [≤1.8 μg/dl]) and ACS (1 mg‐DST > 50 nmol/L [> 1.8 μg/dl]) was established according to current guidelines. The control group was selected based on a normal adrenal imaging exam. Results There were no differences between groups regarding age, gender, ethnicity, menopause or body mass index. Patients with adrenal incidentaloma presented higher frequency of hypertension (74.1 vs. 57.8%; p = .02), resistant hypertension (45.4 vs. 9.4%; p < .001), dyslipidemia (80.1 vs. 63.9%; p = .01), as well as metabolic syndrome (84.2 vs. 61.7%; p = .001) compared to the controls, respectively. NFAI and ACS patients presented similar frequency of arterial hypertension (70.8 vs. 79.3%) and resistant hypertension (41.3 vs. 51.1%), dyslipidemia (79.3 vs. 81.5%) and metabolic syndrome (83.3 vs. 85.7%); also, levels of HbA1c were similar between the groups. Binary logistic regression showed that NFAI (p = .004) and ACS (p = .001) were independent predictors for resistant hypertension (p = .003); also, ACS was an independent predictor for metabolic syndrome (p = .04). Conclusions NFAI and ACS presented a higher frequency of cardiometabolic morbidities in comparison with individuals with normal adrenal glands. Additionally, we demonstrated that both ACS and NFAI groups have similar cardiometabolic conditions.

Do Non-Functional Adrenal Adenomas Affect Metabolic Profile and Carotid Intima-Media Thickness? A Single Centre Study from Poland

“…In the study by Rabelo et al patients with AI presented higher frequency of hypertension (74.1 vs. 57.8%; p = 0.02), resistant hypertension (45.4 vs. 9.4%; p < 0.001) compared to the controls, respectively. NFAI and ACS patients presented similar frequency of arterial hypertension (70.8 vs. 79.3%) and resistant hypertension (41.3 vs. 51.1%) [41].…”

Are comorbidities of patients with adrenal incidentaloma tied to sex?

“…An additional important limitation is the absence of a comparison group from the general population, which indeed makes it challenging to conclusively assert that the worsening of arterial hypertension and hyperglycemia was specifically due to the AI presence instead of being merely a reflection of the natural aging process. However, studies have shown that patients with AI exhibited a higher prevalence of these comorbidities compared to age-matched controls without AI (60)(61)(62)(63), supporting the notion that AI may contribute to these outcomes more than age alone. Future research should aim to incorporate a comparison to more definitively ascertain the specific impact of AI on the development of cardiometabolic complications.…”