Endocrine Abstracts

Objective: Nonfunctional adrenal masses are a risk indicator of increased cardiometabolic risk. Especially; increased thrombogenic ambient, insulin resistance, hepatosteatosis and abdominal obesity are determined in these patients with nonfunctional adrenal masses. Our purpose was to show the association of adrenal incidentalome and metabolic syndrome in consideration of the studies and to detect the increase in the carotid intima-media thickness which is regarded as the precessor of atherosclerosis.

Material and methods: Eighty one patients who applied to our clinic between 2014 and 2016 were diagnosed with adrenal mass and follow-ups were included in the study. During the first application from the patients, their height/weight, BMI, waist circumference and tension arterial were measured. Participants underwent hormonal evaluation and insulin rezistance with the HOMA-IR. A 1-mg DST test was conducted after evaluating basal cortisol measurements of the patients. After the existence of adrenal mass of the patients was verified with MRG, the patients were classified into two groups: the patients with mass size <3 cm (K₁) and the patients with mass size of at least 3 cm (K₂). Lastly, detailed echocardiography (tissue Doppler and diastolic dysfunction parameters) and carotid intima-media of the patients were measured using B-mode ultrasound. The control group (n=33) was created by choosing healthy volunteers who applied to our polyclinic. While choosing the control group, it was targeted that age, gender distribution, and BMI values of the control group would equal those of the patient group.

Findings: Within the scope of the study, mean mass size of the patients (n=81) with adrenal mass was determined to be 2.5±1.2 cm. Mass size of 64.19% (n=52, K₁) of the patients was found as <3 cm, while mass size of the remainder (35.81%) (n=29, K₂) was calculated to be at least 3 cm. As a result of the analyses, five of the patients with adrenal mass were detected to have subclinical Cushing syndrome. The remaining 76 patients were accepted as nonfunctional. It was seen with regard to metabolic and biochemical parameters that plasma glucose (P=0.01), insulin (P=0.00) and triglyceride (P=0.012) values of NFAİ and SCS patients were significantly high compared to those of the control group. It was detected that measured heart rate (P=0.00), end-diastolic diameter (EDÇ) (P=0.02), end-systolic diameter (ESÇ) (P=0.014) and carotid intima-media thickness (CIMT)(P=0.00) values of the patients with adrenal mass (n=81) were significantly higher than those of the healthy control group.

Result: We see the increased insulin resistance, increased risk of cardiovascular disease with the increase in the thickness of carotid intima-media and diastolic disfunction parameters, although the patients with adrenal incidentaloma are nonfunctional.