Endocrine Abstracts

Adrenal adenomas are characterised with metabolic disturbances. The aim of this study is to demonstrate the changes in some metabolic and anthropometric parameters after 24 months follow up in subjects with non-functioning adrenal adenomas.

Subjects referred between 2001 and 2008 for the evaluation of adrenal tumours were included. Computed tomography (CT) was the initial radiological intervention. Initial hormonal evaluation included 1 mg or 2 day 2 mg dexamethasone suppression test, urinary free cortisol (UFC), 08.00 a.m. ACTH and DHEAS levels. In subjects with elevated post DST cortisol (>1.8 mcg/dl), elevated UFC (>110 mcg/day), and suppressed ACTH and DHEAS levels, midnight cortisol was evaluated (normal < 7.5 mcg/dl). Urinary catecholamine excretion and aldosterone/renin ratio were also measured. BMI, waist circumference, blood pressure were recorded. Fasting plasma glucose, fasting insulin, lipid parameters, hsCRP and fibrinogen were measured.

Of 140 subjects with adrenal adenomas were included. There were 106 subjects with non-functioning adenomas and 34 patients with subclinical Cushing syndrome or overt adrenal Cushing Syndrome. Median follow up duration was 24 months. Mean age was 55 years and female dominance was present (104/36).

We showed that, in subjects with non functioning adrenal adenomas, after a 24 months follow up, new onset hypertension was diagnosed in 19% of the normotensive subjects (P=0.004, Mc-Nemar) and new onset hyperlipidemia was diagnosed in 46% (P<0.001, Mc-Nemar) of the subjects with normal lipid values. The rate of diabetes development was 5%. We also showed that BMI, fasting glucose, total cholesterol and LDL-cholesterol increased and DHEAS levels decreased significantly after follow up in subjects with adrenal adenomas.

Adrenal adenomas even non functioning ones may be associated with future metabolic risks. Close monitoring and treatment of traditional risk factors should be taken into consideration in subjects with adrenal adenomas.