Endocrine Abstracts

Introduction: Neuropsychiatric disorders are common and well-studied in patients with overt hypercortisolism. However, data regarding patients with adrenal incidentalomas (AIs) are limited. The aim of our study is to assess the psychometric and quality of life status in individuals with benign adrenal tumours.

Methods: Eighty-two patients diagnosed with AIs, encompassing 53 females and 29 males, with a total mean age of 64 years and 52controls (without AI in computed tomography scan) were included. Functional profile was based on a complete hormonal work-up including serum levels of cortisol at baseline at 8:00 am and post-1 mg overnight dexamethasone suppression test (ODST), adrenocorticotropic hormone (ACTH) levels, plasma renin activity and aldosterone levels, adrenal androgens and catecholamines levels. Psychometric analysis and quality of live status were evaluated based on established generic questionnaires, such as the European Quality of Life (EuroQoL-5D-5L) and the Depression, Anxiety, Stress Scale (DASS-21). Oncological patients were excluded.

Results: Based on the ODST cortisol levels, patients were categorized into three distinct groups: Group 1 was consisted of patients with non-functional AIs (NFAIs) exhibiting ODST cortisol levels below 1,8 μg/dl (n=42), group 2 included patients with possible autonomous cortisol secretion (PACS) with cortisol levels ranging between 1.8-3 μg/dl (n=23) and group 3 included patients with autonomous cortisol secretion (ACS) with cortisol levels above 3μg/dl (n=14). Statistical analysis revealed a statistically significant difference in the overall DASS scores among the three groups (p-value <0.0001). Post-hoc tests revealed specific group differences, with ACS patients presenting higher total DASS score compared to NFAIs (28.5 ± 13.3 vs 10.4 ± 8.5, P <0.001) and compared to PACS patients (28.5 ± 13.3 vs 20.65 ± 8,63, P=0.048). Significant difference was also shown between NFAIs and PACS (10.98 ± 8.4 vs 20.65 ± 8.63, P=0.04). Controls presented lower DASS score compared to NFAIs (4.93 ± 7.37 vs 10.98 ± 8.4, P=0.046). These findings were corroborated by the validated EuroQoL domain reflecting compromised anxiety and depression.

Conclusion: The results of our study showed that individuals with AIs even those without overt Cushing syndrome (PACS and NFAI) might exhibit mental impairment or psychological consequences, highlighting the significance of screening for these disorders besides the well-studied metabolic abnormalities.