Endocrine Abstracts

Background: The diagnosis of adrenal incidentaloma (AI) is becoming more common with the rising use of radiological tests. Most of AI are nonfunctional adrenal incidentalomas (NFAI) that may produce small amounts of glucorcorticoids that, in consequence, may cause metabolic disorders. Metabolic syndrome being a significant health concern should be evaluated in patients with NFAI. The objective of the study was to assess metabolic syndrome (MS) prevalence and characteristics in NFAI patients according to International Diabetes Federation (IDF) criteria compared to a control group.

Methods: This case-control study included 40 NFAI patients (16 men, 24 women, mean age 52.9±11.2 years) and 40 individuals (17 men, 23 women, mean age 56.8±8 years) in the control group matched for age, sex, and weight. NFAI diagnosis was established according to current guidelines. Patients with mild autonomous cortisol secretion, chronic kidney disease, liver failure or under hypolipidemic drugs, combined contraceptive pills, alcohol or depression, were excluded of this study All participants underwent physical examination (waist circumference (WC), blood pressure), adrenal imaging, and biochemical evaluation including triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), cholesterol total (CT) and fasting plasma glucose (FPG). All participants underwent the assesment of characteristics of the metabolic syndrome according to IDF.

Results: The NFAI group had significantly higher WC (P<0.02), higher obesity (P=0.025) higher fasting plasma glucose (P=0.014), higher score of metabolic syndrome according to IDF (3 (2-3) vs 2 (1-3), P=0.076) and higher prevalence of metabolic syndrome (21 patients (53%) vs 12 patients (30%); P=0.041) compared to the control group. NFAI was positively associated with metabolic syndrome (OR= 2.58; 95% confidence interval (CI): 1.03-6.46; P=0.041). Obesity (OR=7.29, IC: 1.74-30.56, P=0.001) and female genre (OR=7.29; IC: 1.74-30.56; P=0.004) were positively correlated to metabolic syndrome in NFAI patients. In multivariate analyses including gender, WC, hypertension and diabetes, NFAI was not a factor independently associated with metabolic syndrome (P=0.862).

Conclusion: NFAI are common and they are associated with adverse metabolic changes. Threshold, NFAI should be considered as an innovative factor for metabolic syndrome.