Endocrine Abstracts

Background: Incidentally discovered adrenal tumours have become a common clinical problem. The presence of an adrenal incidentalomas has been associated with an increase incidence of several cardiovascular risk factors. These abnormalities are more frequent in patients with clinical and subclinical hypercortisolism, nevertheless some studies have reported an association between nonfunctioning adrenal incidentalomas (NFAIs) with increased insulin resistance and cardiovascular risk.

Aim: The aim of the study was to identify features of cardiometabolic risk in patients with NFAIs.

Material and methods: Fifty-one patients with adrenal incidentaloma and negative screening testes to rule out catecholamine, mineralocorticoid and glucocorticoid overproduction were included in the study. Retrospective analysis based on clinical parameters and results of imaging and laboratory procedures was conducted. Features such as BMI, hypertension, abnormal parameters of glucose and lipid metabolism were assessed. Cardiovascular risk was estimated with SCORE (The European Systematic Coronary Risk Evaluation).

Results: We investigated 51 patients with NFAIs (67% were females) with mean age of 61±10 years. The mean adrenal mass size was 21.5±9.3 mm; 30% had bilateral incidentalomas.

Excessive body mass was observed in about 66% of patients: 38.3% were overweight and 27.7% obese. Hypertension was observed in 60% of patients. Type 2 diabetes was diagnosed in 29.4%, impaired fasting glucose in 27.5% cases and median HOMA-IR was 4.3. SCORE system classified as low risk 3.9% of patients, moderate risk 41.2%, high risk 15.7% and very high risk 39.2%. Among patients with low or moderate risk 56.5% had LDL-c levels above 115 mg/dl; 62.5% of patients with high risk had LDL-c higher than 100 mg/dl and all patients with very high risk had LDL-c over 70 mg/dl.

Conclusion: Patients with NFAIs have high cardiometabolic risk. Cardiovascular features should be screened during their initial workup and follow-up to identify those at risk and implement the appropriate interventions.