ECE2022 Eposter Presentations Adrenal and Cardiovascular Endocrinology (131 abstracts)
Clinical sexual dimorphism in patients with adrenal incidentaloma and (possible) autonomous cortisol secretion
Ljiljana Marina 1 , Miomira Ivovic 2 , Antoan Stefan Sojat 1 , Bogdan Dugic 3 , Milina Tancic-Gajic 2 , Zorana Arizanovic 1 , Kristina Saravinovska 4 , Dunja-Simona Petkovic 4 , Tijana Petkovic 1 , Natalija Antic 1 , Aleksandra Kendereski 2 & Svetlana Vujovic 2
1Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Department for Obesity, Metabolic and Reproductive Disorders, Belgrade, Serbia; 2Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Department for Obesity, Metabolic and Reproductive Disorders, Belgrade, Serbia; 3School of Electrical Engineering, University of Belgrade, Belgrade, Serbia; 4Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Introduction: Many diseases of the adrenal cortex show a higher prevalence in women than men with incidence increasing with age in both genders.
Aim: The aim was to determine the possible sexual dimorphism in patients with adrenal incidentaloma (AI) and (possible) autonomous cortisol secretion ((P)ACS).
Methods: This was an observational, cross-sectional study of 381 patients with AI that were functionally assessed in our Clinic. After exclusion of patients with overt adrenal hyperfunction, malignancy, cysts and nonfunctional AI, the studied group consisted of 186 patients with (P)ACS: 138 female and 48 males. Based on average menopause age of 51, we stratified women in two groups: < 51 and ≧ 51. For the sake of comparison, we age-matched the male group, and evaluated differences in body mass index (BMI), adrenal tumor size (ATS), localization, ACTH, 24 h cortisol, 1 mg dexamethasone suppression cortisol (1 mg DST), and prevalence of hypertension (HTA) and type 2 diabetes mellitus (T2DM).
Results: Female sex was predominant in the whole cohort (F/M % 74.2/25.8) and in both age groups (< 51 years, 33 patients – F/M % 87.8/12.2 and ≧ 51 years, 153 patients – F/M % 71.2/28.8), with a higher frequency in younger group when compared to males (P=0.048). There was no difference in age, BMI, ATS, localization, ACTH, 24 h cortisol, 1 mg DST cortisol, HTA and T2DM prevalence between female and male patients. Older male patients had a higher prevalence of T2DM (P=0.035) than younger males with 24 h cortisol level being the most significant predictor of T2DM (P=0.047). There was no difference in prevalence of HTA, nor other significant differences between younger and older male patients. In the female group, there was no difference in HTA and T2DM prevalence between younger and older patients. In older female patients ATS was the most significant predictor of T2DM (B=0.247, 95% CI B=0.002–0.018, P=0.011) while BMI was the most significant predictor of HTA (B=0.301, 95% CI B=0.009–0.031, P=0.002), whereas there were no detectable significant predictors in younger females for both T2DM and HTA.
Conclusion: Female gender is a predisposing factor for subtle cortisol hypersecretion in patients with AI, while also being a predisposing factor for cardiometabolic comorbidities in women younger than 51 years of age, thus pointing to a relevant clinical sexual dimorphism that could aid in providing a decision-making process and tailored treatment.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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