ECE2022 Poster Presentations Late-Breaking (41 abstracts)
1Ankara City Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey; 2Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
Backgorund: Adrenal incidentalomas (AI) are lesions discovered incidentally on imaging without clinical symptoms or examination findings. AI can produce hormones in 5-30% of cases. Autonomic cortisol secretion (ACS) is the most common of these. Although ACS is asymptomatic, it increases the risk of metabolic disorders.
Methods: Patients aged<18 years with adrenal adenoma and upper abdominal MRI who presented and were examined in the endocrinology outpatient clinic, had their data retrospectively documented. Comorbidities, examinations and hormonal tests and results of these patients were evaluated. Those who failed dexamethasone suppression tests (cortisol >1.8 g/dl) and did not have Cushings syndrome were classified as ACS.
Results: Among the 223 patients, 138 (61.9%) were women with a median age of 56 (18-80). Of the patients, 26.9% had diabetes mellitus (DM), 54.3% had hypertension (HT), 17.9% had hyperlipidemia (HL), 12.1% had coronary artery disease (CAD), 1.3% had heart failure (HF). Hormone testing revealed that 6 (2.6%) of the patients had primary aldosteronism, 5 (2.2%) had pheochromocytoma, and 35 (15.6%) had ACS. Patients with and without ACS were compared for the presence of other additional diseases and adenoma size (Table-1). DM, HT and HL were higher in the ACS group (P<0.05, for each). Adenoma size was larger in the ACS group (P<0.05). Both groups had comparable age and sex distribution (P>0.05).
Autonomic cortisol secretion | Yes | No | P |
Sex, Woman/Man | 2.18 | 1.54 | 0.45 |
Age (years), median (min-max) | 59 (36-80) | 55 (18-74) | 0.071 |
Size of adenoma (mm) | 25 (10-54) | 18 (10-60) | 0.001 |
T2DM | 17 (48.6%) | 43 (22.9%) | 0.002 |
HT: | 25 (71.4%) | 96 (51.1%) | 0.028 |
HL: | 13 (37.1%) | 27 (14.4%) | 0.003 |
CAD: | 7 (20%) | 20 (10.6%) | 0.154 |
HF: | 1 (2.9%) | 2 (1.1%) | 0.402 |
Osteoporosis or osteopenia | 6 (30%) | 13 (56.5%) | 0.125 |
T2DM type 2 diabetes mellitus, HT hypertension, HL hyperlipidemia, CAD coronary artery disease, HF heart failure |
Conclusion: İndividuals with large adenomas are more likely to have ACS. Large adrenal adenomas should be monitored for ACS and associated cardiometabolic risks, as well as necessary treatments.