Endocrine Abstracts

Introduction: Non-functioning adrenal incidentaloma (NFAI) is a frequently diagnosed since the increased use of radiological examinations. The recent studies have shown that NFAI might have negative cardiometabolic effects and increased cardiovascular risk. The aim of this case control study was to determine the relationship between NFAI, CRP-hs, uric acid and cardiovascular risk (CVR) based on GLOBORISK algorithm of Tunisia.

Methods: This case-control study included 40 NFAI patients (16 men, 24 women, mean age 52.9±11.2 years) and 40 individuals (17 men, 23 women, mean age 56.8±8 years) in the control group matched for age, sex, and weight. NFAI diagnosis was established according to current guidelines. Patients with mild autonomous cortisol secretion, chronic kidney disease, liver failure or under hypolipidemic drugs, combined contraceptive pills or alcohol were excluded of this study. All participants underwent physical examination, adrenal imaging, biochemical evaluation including baseline cortisol, CRP-hs, lipid profile, uric acid, and fasting plasma glucose (FPG). All participants underwent the assessment of the 10-year risk of cardiovascular mortality based on the GLOBORISK algorithm of Tunisia.

Results: NFAI presented higher basal cortisol level (10.4 µg/dl (8.0-13.2) vs 8.0 µg/dl (7.0-10.6), P=0.007), higher uric acid level (51.8 ± 15.3 mg/l vs 43.3 ± 11.2 mg/l P=0,009) and higher CRP-hs (2.5 mg/l (1.3-4.6) vs 0.9 mg/l (0.43-1.98), P <10^-3) compared to control group. Using the GLOBORISK algorithm, NFAI didn’t present a higher cardiovascular risk compared to controls. Age (r=0.692, P<10^-3) and systolic hypertension (r=0.384, P=0.014) were positively correlated to a higher CVR in NFAI patients. Basal cortisol level superior to 10 μg/dl and uricemia superior to 55 mg/l were associated with elevated CVR with odds ratios of 3.73 (95% CI:1.02-14.23) and 5.14 (95% CI:1.29-20.52) respectively.

Conclusion: This study confirms that cardiovascular remodelling in asymptomatic patients with NFAI can be detected in early stages. Therefore, NFAI having higher cardiovascular risk should be monitored regularly.