Endocrine Abstracts

Introduction: Natural history of adrenal incidentalomas has not been totally understood. Current data from subjects with adrenal incidentalomas demonstrated an increased rate of metabolic disturbances and cardiovascular risk. It has been shown that subjects with subclinical cortisol excess were more susceptible to diabetes, hypertension, and obesity. However, there is no data regarding prospective cardiovascular risk evaluation in subjects with subclinical Cushing’s syndrome.

Methods: Patients referred to Dokuz Eylul University between January 2013 and January 2014 were included. Patients with subclinical Cushing’s syndrome (n=20), patients with non functioning adrenal adenomas (n=30) and subjects without adrenal adenomas (n=25) were enrolled. Interventions included physical examination, anthropometric measures, imaging with CT (MRI if CT was contraindicated), 1 mg DST, ACTH, UFC, urinary catecholamine levels, PAC/PRA (if indicated), hcCRP, lipid profile, HOMA index, and fibrinogen levels. Additionally all subjects underwent carotid intima media thickness (IMT) measurement and evaluation of flow mediated dilatation (FMD) of the brachial artery All laboratory tests were repeated in both groups after 12 months follow up.

Results: Baseline anthropometric parameters were comparable. Briefly, patients with subclinical Cushing’s syndrome did not exhibit any deteriorations in IMT of the carotid arteries or FMD of brachial artery after 12 months follow up.

Discussion: Although subclinical Cushing’s syndrome is associated with several cardio-metabolic disturbances, endothelial function does not seem to be altered in 12 months follow up. Therefore, the decision of adrenalectomy vs follow up should be conservative and short-term follow up seems feasible.