Increased risk of unfavorable metabolic outcome during short-term follow-up in subjects with nonfunctioning adrenal adenomas

Med Princ Pract. 2012;21(5):429-34. doi: 10.1159/000336589. Epub 2012 Mar 2.

Abstract

Objective: To demonstrate long-term changes in the prevalence of several types of metabolic derangements in subjects with nonfunctioning adrenal adenomas.

Subjects and methods: 273 subjects with adrenal adenomas, including 231 with nonfunctioning adenoma and 42 with subclinical Cushing's syndrome (sCS), were evaluated with respect to anthropometric and laboratory characteristics and prevalence of type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia, metabolic syndrome (MS), prediabetes and cardiovascular disease (CVD). Median duration was 24 months. Follow-up data of 114 participants with nonfunctioning adrenal adenomas are also presented while those of 117 were missing. Follow-up data regarding changes in anthropometric and laboratory parameters and prevalence rates of metabolic disturbances were obtained from the medical records.

Results: The prevalence rates for both patients with nonfunctioning adenoma and sCS were: dyslipidemia: 161 (59%), hypertension: 147 (54%), MS: 128 (47%), prediabetes: 62 (23%), T2DM: 49 (18%), and CVD: 21 (8%). Hypertension and CVD were prevalent in subjects with sCS compared to participants with nonfunctioning adenoma. In follow-up, body mass index (p = 0.005), systolic blood pressure (p < 0.001), waist circumference (p = 0.005), homeostasis model assessment (p = 0.046), high-sensitivity C-reactive protein (p = 0.023), total cholesterol (p < 0.001) and low-density lipoprotein cholesterol (p < 0.001) and prevalence of hypertension (p < 0.001), dyslipidemia (p < 0.001), prediabetes (p < 0.001) and MS (p < 0.01) significantly increased in subjects with nonfunctioning adenoma.

Conclusion: The data showed that nonfunctioning adrenal adenomas were associated with the development or deterioration of atherosclerotic risk factors. Therefore, follow-up and management strategies should be developed to decrease atherosclerotic morbidity in those individuals.

MeSH terms

  • Adenoma / epidemiology*
  • Adenoma / metabolism
  • Adrenal Gland Neoplasms / epidemiology*
  • Adrenal Gland Neoplasms / metabolism
  • Adult
  • Aged
  • Blood Pressure
  • Body Weights and Measures
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / metabolism
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / metabolism
  • Humans
  • Lipids / blood
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / metabolism
  • Middle Aged
  • Pituitary ACTH Hypersecretion / epidemiology
  • Pituitary ACTH Hypersecretion / metabolism
  • Prevalence

Substances

  • Lipids