Endocrine Abstracts

Background: Cardiovascular (CVS) risk factors could be present in patients with mild adrenal autonomous cortisol secretion (MACS), which could account for up to 50% of patients with adrenal adenomas. However, the most frequent CVS risk factors in MACS have not been established.

Objective: The aim of the present study was to analyse the difference in CVS risk factors in patients with MACS in comparison to those with non-functioning adrenal tumour (NFAT).

Materials and Methods: A total of 295 patients with adrenal incidentaloma who were hospitalised in the single-center between 2017 and 2019 were included in this retrospective study. All patients underwent a 1 mg overnight dexamethasone suppression test (DST). We divided our group into those who showed suppression in the DST (NFAT) and those who did not show suppression in the DST (MACS). In the studied groups, we analysed the presence of CVS risk factors, such as obesity, prediabetes (PD), type 2 diabetes mellitus (T2DM), hypertension, hyperlipidaemia, and chronic kidney disease.

Results: In our study, 18.9% of patients were defined as MACS, and the remaining 80.1% of patients were defined as NFAT. In the group with MACS, we observed obesity in 33.9%, whereas in NFAT, the prevalence of obesity was 34.7% (P=0.9). Hypertension was diagnosed in 78.5% of MACS vs. 69.5% of NFAT (P=0.2), whereas chronic kidney disease was observed in 32.1% of MACS vs. 28.5% of NFAT (P=0.7). Accordingly, we did not find differences in the diagnosis of prediabetes in MACS vs. NFAT (26.8% vs. 34.3% (P=0.35)). Importantly, T2DM was diagnosed in 41% of MACS vs. 23% of NFAT (P<0.01). Interestingly, we observed a higher frequency of occurrence of hyperlipidaemia in NFAT (72.4%) vs. MACS (53.6%) (P=0.01). Accordingly, in patients without T2DM, MACS was observed in 15.2%, in comparison to 29.5% in patients with T2DM (P<0.01).

Conclusions: In our retrospective analyses, we found that T2DM is more prevalent in MACS than in NFAT, whereas hyperlipidaemia is more prevalent in NFAT. Accordingly, no differences were observed in the incidence of obesity, hypertension, prediabetes, or kidney damage in NFAT and MACS patients. This could suggest that mild hypercortisolaemia is not associated with a higher CVS risk in comparison to NFAT.