Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas

Abstract

Purpose of review The incidence of adrenal tumors has increased over the past 20 years, most of which are incidentally discovered nonfunctioning adenomas (NFA) and tumors with mild autonomous cortisol secretion (MACS). This review aimed to summarize recent progress in understanding cardiometabolic risk in patients with NFA and MACS and to provide updates on the effect of treatment on improving outcomes in this population. Recent findings NFA and MACS are associated with adverse cardiovascular risk factors and metabolic derangements, which are likely mediated by excessive glucocorticoid secretion. Recent studies showed significantly higher prevalence of hypertension, impaired glucose metabolism, obesity, and dyslipidemia in patients with NFA and MACS. Adrenalectomy may improve comorbidities in selected patients. Summary Asymptomatic adrenal adenomas are common and are associated with adverse cardiometabolic changes. In selected patients, adrenalectomy may reduce cardiometabolic risk and improve clinical outcomes.

Cardiometabolic profile and urinary metabolomic alterations in non‐functioning adrenal incidentalomas: A review

“…[24][25][26][27][28] Over the last few years, new discoveries have emerged regarding the deleterious effects of ACS, such as an increased risk of periodontitis, 29 mental disorders, and worsening of quality of life. 30 Although with less evidence than in ACS, but increasing, a greater cardio-metabolic risk has been found in patients with apparently NFAIs than in the general population [10][11][12]14,[31][32][33][34][35] (Figure 1 and Table 1). In fact, in a recent study, 36 it has been observed that the cardio-metabolic risk of patients with ACS and NFAI was higher than in the general population, but did not differ between the two groups when a stratification by body mass index (BMI) was performed, which suggests that both entities are equally deleterious for the cardiometabolic system.…”