Adrenal incidentaloma as a novel independent predictive factor for periodontitis

J Endocrinol Invest. 2021 Nov;44(11):2455-2463. doi: 10.1007/s40618-021-01557-w. Epub 2021 Mar 31.

Abstract

Purpose: There are no data regarding periodontal derangements in patients with adrenal incidentalomas (AI). We assessed the frequency and severity of periodontitis in patients with AI [non-functioning adrenal incidentaloma (NFAI) and possible autonomous cortisol secretion (ACS)] and compared with individuals with normal adrenal.

Methods: A cross-sectional study evaluated thirty-five individuals with AI and 26 controls. NFAI and possible ACS diagnosis was based on the current guidelines: NFAI [cortisol levels after 1 mg dexamethasone suppression test (1 mg-DST) ≤ 1.8 µg/dL (≤ 50 nmol/L)]; possible ACS [cortisol levels after 1 mg-DST 1.9-5.0 µg/dL (51-138 nmol/L)]. Sociodemographic data were collected, and a full-mouth periodontal evaluation was performed.

Results: There was no significant difference between groups regarding age, sex, income, ethnicity, education level, smoking, body mass index, dysglycemia, and arterial hypertension. Patients with AI exhibited worse periodontal conditions than controls for the following periodontal clinical parameters: mean percentage of probing pocket depth (PPD) and clinical attachment level (CAL) ≥ 5 mm (p < 0.001 and p = 0.006, respectively). Patients with NFAI and possible ACS showed higher gingival bleeding index (p = 0.014), bleeding on probing (p < 0.001), and CAL (p < 0.001) means compared to controls. The frequencies of periodontitis were 72.7% in patients with NFAI, 84.6% in possible ACS, and 30.8% in controls (p = 0.001). Periodontitis was more severe in patients with possible ACS than NFAI and controls. Patients with NFAI and possible ACS exhibited odds ratio for periodontitis of 4.9 (p = 0.016) and 8.6 (p = 0.02), respectively.

Conclusion: Patients with AI have higher frequency and severity of periodontitis than controls. The presence of AI was an independent predictive factor for periodontitis.

Keywords: Adrenal incidentaloma; Autonomous cortisol secretion; Non-functioning adrenal incidentaloma; Periodontal disease; Periodontitis.

Publication types

  • Observational Study

MeSH terms

  • Adrenal Gland Neoplasms* / diagnosis
  • Adrenal Gland Neoplasms* / metabolism
  • Adrenal Gland Neoplasms* / physiopathology
  • Adrenal Glands* / metabolism
  • Adrenal Glands* / pathology
  • Adrenal Glands* / physiopathology
  • Cross-Sectional Studies
  • Diagnosis, Oral / methods
  • Diagnostic Techniques, Endocrine
  • Female
  • Humans
  • Hydrocortisone* / biosynthesis
  • Hydrocortisone* / blood
  • Male
  • Middle Aged
  • Periodontitis* / diagnosis
  • Periodontitis* / physiopathology
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment / methods
  • Risk Factors
  • Severity of Illness Index
  • Sociodemographic Factors

Substances

  • Hydrocortisone

Supplementary concepts

  • Adrenal incidentaloma