Endocrine Abstracts

Introduction: It is well known that DHEA and DHEA-S has and impact on lipid metabolism, cardiovascular system and others. De Castro et al. showed that cortisol/DHEA-S ratio was an independent predictor of long-term mortality in patients with sepsis. Chronic inflammation is an important factor in cardiovascular diseases development that reduce quality and life expectancy. CVDs are more common in patients with adrenal incidentaloma than in general population. Literature data on the cortisol/DHEA-S ratio are contradictory, there are no scientific studies in the group of patients with endocrinopathies, including adrenal incidentalomas.

Aim: The aim of the study was to evaluate inflammation indicators – old one: insulin, CRP and new one: PLR (platelet-lymphocyte ratio), MPVLR (MPV-to-lymphocyte ratio), NLR (neutrophil-lymphocyte ratio), SII (systemic immune-inflammation index) in group of patients with non-functioning adrenal incidentalomas.

Material and methods: The study included 150 patients with non-functioning adrenal incidentalomas hospitalized in Endocrinology City Hospital in Piekary in 2016-2019. The exclusion criteria were mainly: other adrenal disorders (e.g. secreting adrenal adenomas, overactive adrenal cortex), decompensated diabetes defined as HBA1C%>7, kidney failure as eGFR<60 ml/min/1,73 m² liver failure as bilirubin>2 mg/dl, INR>1,5 and albumins<3,5 g/dl, severe inflammation, treated cancer disease. Morphology parameters, cortisol and DHEA-S concentration (taken from the patient’s medical record) were used to calculate inflammatory indicators and cortisol/DHEA-S ratio, CRP and insulin concentration was also taken from medical record.

Results: Most of the respondents (n= 150) were women (72.67%). The median age was 62 years in women, 66 years in men (P=0.00), cortisol concentration at 8 a.m. was 278.62 nmol/l in women, 320 nmol/l in men (P=0,00), DHEA-S was 78,8 µg/dl in women, 102,5 µg/dl in men (P<0,05), CRP was 1,69 in women, 1,5 in men (P>0,05), MPVLR 5,33 in women, 5,32 in men (P=0,00). There was negative correlation observed (P<0,05) between cortisol/DHEA-S ratio and: CRP (r=-0,21), insulin (r=-0,18). There was no signifficant correlation (P>0,05) demonstrated between analyzed cortisol/DHEA-S ratio and new inflammation indicators: MPVLR, SII, PLR, NLR.

Conclusion: There is association between cortisol/DHEA-S ratio and old inflammation indicators but not between cortisol/DHEA-S ratio and new ones in studied group of patients with non-functioning adrenal incidentalomas. There is a necessity to enlarge the studied group to confirm obtained results.