Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?

Yorulmaz, Goknur; Yağız, Burcu; AKALIN, AYSEN; Yağız, Onur; MACUNLUOĞLU, Aslı Ceren

doi:10.18621/eurj.872835

Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?

Burcu YAĞIZ, (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Eskişehir, Türkiye)

Aysen AKALIN, (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, Endokrinoloji ve Metabolizma Bölümü, Eskişehir, Türkiye)

Goknur YORULMAZ, (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, Endokrinoloji ve Metabolizma Bölümü, Eskişehir, Türkiye)

Aslı Ceren MACUNLUOĞLU, (Bursa Uludağ Üniversitesi, Tıp Fakültesi, Biyoistatistik Bölümü, Bursa, Türkiye)

Onur YAĞIZ (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, Endokrinoloji ve Metabolizma Bölümü, Eskişehir, Türkiye)

The European Research Journal

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Yıl: 2022 Cilt: 8 Sayı: 6 Sayfa Aralığı: 747 - 754 Metin Dili: İngilizce DOI: 10.18621/eurj.872835 İndeks Tarihi: 13-01-2023

Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?

Öz:

Objectives: We aimed to evaluate the potential association of a nonfunctional adrenal incidentaloma (NFAI) with cardiovascular risk factors. Methods: Forty-three patients over the age of 40 found to have NFAI and 28 healthy controls were included in this prospective study. The control group was selected from individuals who were similar in age and gender. Glucose, insulin, c-peptide, lipid profile, erythrocyte sedimentation rate, high sensitivity c-reactive protein, fibrinogen and 25-hydroxy cholecalciferol and carotid artery intima-media thickness (CIMT) were measured in both groups. Results: Waist circumference, erythrocyte sedimentation rate, triglyceride and CIMT values were found higher in the patient group (p = 0.002, p < 0.001, p = 0.001, p = 0.024, respectively). It was observed that 10 (23.2%) of the patients had no suppression with 1 mg dexamethasone but suppression was provided with 2 mg dexamethasone for 2 days, and all of these patients with ‘possible autonomous cortisol secretion’ had at least one comorbidity. While there was no significant difference between the groups in terms of the presence of comorbidity, a significant difference was found in terms of diabetes mellitus (90% of the patients with autonomous cortisol secretion, 24.2% of those who were suppressed with 1 mg dexamethasone had diabetes mellitus; p < 0.001; Chi-square test). Conclusions: Higher waist circumference, erythrocyte sedimentation rate, triglyceride and CIMT values in our patients with NFAI and increased diabetes mellitus frequency in patients with autonomous cortisol secretion suggest that NFAI may be one of the cardiovascular risk factors.

Anahtar Kelime: Autonomous cortisol secretion cardiovascular risk carotid intima-media thickness non-functional adrenal incidentaloma

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Prager G, Peer GH, Passler C, Kaczirek K, Schindl M, Scheuba C, et al. Surgical strategy in adrenal masses. Eur J Radiol 2002;41:70-7.
2. Terzolo M, Pia A, Alì A, Osella G, Reimondo G, Bovio S, et al. Adrenal incidentaloma: a new cause of the metabolic syndrome? J Clin Endocrinol Metab 2002;87:998-1003.
3. Fernández-Real JM, Engel WR, Simó R, Salinas I, Webb SM. Study of glucose tolerance in consecutive patients harbouring incidental adrenal tumours. Clin Endocrinol (Oxf) 1998;49:53-61.
4. Rossi R, Tauchmanova L, Lucano A, Di Martino M, Battista C, Del Viscovo L, et al. Subclinical Cushing’s syndrome in patients with adrenal incidentaloma: clinical and biochemical features. J Clin Endocrinol Metab 2000;85:1440-8.
5. Di Dalmazi G, Vicennati V, Rinaldi E, Morselli-Labate AM, Giampalma E, Mosconi C, et al. Progressively increased patterns of subclinical cortisol hypersecretion in adrenal incidentalomas differently predict major metabolic and cardiovascular outcomes: a large cross-sectional study. Eur J Endocrinol 2012;166:669-77.
6. Di Dalmazi G, Vicennati V, Garelli S, Casadio E, Rinaldi E, Giampalma E, et al. Cardiovascular events and mortality in patients with adrenal incidentalomas that are either non-secreting or associated with intermediate phenotype or subclinical Cushing’s syndrome: a 15-year retrospective study. Lancet Diabetes Endocrinol 2014;2:396-405.
7. Morelli V, Reimondo G, Giordano R, Casa SD, Policola C, Palmieri S, et al. Long-term follow-up in adrenal incidentalomas: an Italian multicenter study. J Clin Endocrinol Metab 2014;99:827-34.
8. Debono M, Bradburn M, Bull M, Harrison B, Ross RJ, Newell-Price J. et al. Cortisol as a marker for increased mortality in patients with incidental adrenocortical adenomas. J Clin Endocrinol Metab 2014;99:4462-70.
9. Sbardella E, Minnetti M, D'Aluisio D, Rizza L, Di Giorgio MR, Vinci F, et al. Cardiovascular features of possible autonomous cortisol secretion in patients with adrenal incidentalomas. Eur J Endocrinol 2018;178:501-11.
10. Midorikawa S, Sanada H, Hashimoto S, Suzuki T, Watanabe T. The improvement of insulin resistance in patients with adrenal incidentaloma by surgical resection. Clin Endocrinol (Oxf) 2001;54:797-804.
11. Erbil Y, Ademoğlu E, Ozbey N, Barbaros U, Yanik TB, Salmaslioğlu A, et al. Evaluation of the cardiovascular risk in patients with subclinical Cushing syndrome before and after surgery. World J Surg 2006;30:1665-71.
12. Colao A, Pivonello R, Spiezia S, Faggiano A, Ferone D, Filippella M, et al. Persistence of increased cardiovascular risk in patients with cushing’s disease after five years of successful cure. J Clin Endocrinol Metab 1999;84:2664-72.
13. Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 2016;175:G1-34.
14. Grumbach MM, Biller BKM, Braunstein GD, Campbell KK, Carney JA, Godley PA, et al. Management of the clinically inapparent adrenal mass (‘incidentaloma’). Ann Intern Med 2003;138:424-9.
15. Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein SR. The clinically inapparent adrenal mass: update in diagnosis and management. Endocr Rev 2004;25:309-40.
16. Kloos RT, Gross MD, Francis IR., Korobkin M, Shapiro B. Incidentally discovered adrenal masses. Endocr Rev 1995;16:460-84.
17. Russi S, Blumenthal HT, Gray SH. Small adenomas of the adrenal cortex in hypertension and diabetes. Arch Intern Med 1945;76:284-91.
18. Nieman LK, Biller BMK, Findling JW, Newell-Price J, Savage, MO, Stewart PM, et al. The diagnosis of Cushing’s syndrome: an endocrine society clinical practice guideline. J Clin. Endocrinol Metab 2008;93:1526-40.
19. Bülow B, Jansson S, Juhlin C, Steen L, Thorén M, Wahrenberg H, et al. Adrenal incidentaloma - Follow up results from a Swedish prospective study. Eur J Endocrinol 2006;154:419-23.
20. Libè R, Dall'Asta C, Barbetta L, Baccarelli A, Beck-Peccoz P, Ambrosi B, Long-term follow-up study of patients with adrenal incidentalomas. Eur J Endocrinol 2002;147:489-94.
21. Terzolo M, Pia A, Reimondo G. Subclinical Cushing’s syndrome: definition and management. Clin Endocrinol 2012;76:12-8.
22. Castro MA, Núñez SMA, Marazuela M. Autonomous cortisol secretion in adrenal incidentalomas. Endocrine 2019; 64:1-13.
23. Ruiz A, Michalopoulou T, Megia A, Näf S, Simón-Muela I, Solano E, et al. Accuracy of new recommendations for adrenal incidentalomas in the evaluation of excessive cortisol secretion and follow-up. Eur J Clin Invest 2019;49:e13048.
24. Bermejo AL, Aguado IH, Vera IJ, Recasens M, Esteve E, Casamitjana R, et al. Sex-specific, independent associations of insulin resistance with erythrocyte sedimentation rate in apparently healthy subjects. Thromb Haemost 2007;97:240-4.
25. Kuller L, Borhani N, Furberg C, Gardin J, Manolio T, O'Leary D, et al. Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the cardiovascular health study. Am J Epidemiol 1994;139:1164-79.
26. Touboul PJ, Elbaz A, Koller C, Lucas C, Adraï V, Chédru F, et al. Common carotid artery intima-media thickness and brain infarction: The etude du profil genetique de l’infarctus cerebral (GENIC) case-control study. Circulation 2000;102:313-8.
27. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999;7;340:14-22.
28. Poredoš, P. Intima-media thickness: Indicator of cardiovascular risk and measure of the extent of atherosclerosis. Vasc Med 2004;9:46-54.
29. Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N, et al. Mannheim carotid intima-media thickness consensus (2004-2006): An update on behalf of the advisory board of the 3rd and 4th Watching the Risk Symposium 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006. Cerebrovasc Dis 2007;23:75-80.
30. Evran M, Akkuş G, Bozdoğan İB, Gök M, Deniz A, Sert M, et al. Carotid intima-media thickness as the cardiometabolic risk indicator in patients with nonfunctional adrenal mass and metabolic syndrome screening. Med Sci Monit 2016;22:991-7.
31. Yener S, Genc S, Akinci B, Secil M, Demir T, Comlekci A, et al. Carotid intima media thickness is increased and associated with morning cortisol in subjects with non-functioning adrenal incidentaloma. Endocrine 2009;35:365-70.
32. Yener S, Baris M, Secil M, Akinci B, Comlekci A, Yesil S. Is there an association between non-functioning adrenal adenoma and endothelial dysfunction? J Endocrinol Invest 2011;34:265-70.
33. Ellis E, Chin PKL, Hunt PJ, Lunt H, Lewis JG, Soule SG. Is late-night salivary cortisol a better screening test for possible cortisol excess than standard screening tests in obese patients with Type 2 diabetes? N Z Med J 2012;125:47-58.
34. Mullan K, Black N, Thiraviaraj A, Bell PM, Burgess C, Hunter SJ, et al. Is there value in routine screening for Cushing’s syndrome in patients with diabetes? J Clin Endocrinol Metab 2010;95:2262-5.
35. Gagliardi L, Chapman IM, Oloughlin P, Torpy DJ. Screening for subclinical cushing’s syndrome in type 2 diabetes mellitus: low false-positive rates with nocturnal salivary cortisol. Horm Metab Res 2010;42:280-4.
36. Cansu GB, Atılgan S, Balcı MK, Sarı R, Özdem S, Altunbaş HA. Which type 2 diabetes mellitus patients should be screened for subclinical Cushing’s syndrome? Hormones 2017;16:22-32.

APA	Yağız B, AKALIN A, Yorulmaz G, MACUNLUOĞLU A, Yağız O (2022). Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. , 747 - 754. 10.18621/eurj.872835
Chicago	Yağız Burcu,AKALIN AYSEN,Yorulmaz Goknur,MACUNLUOĞLU Aslı Ceren,Yağız Onur Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. (2022): 747 - 754. 10.18621/eurj.872835
MLA	Yağız Burcu,AKALIN AYSEN,Yorulmaz Goknur,MACUNLUOĞLU Aslı Ceren,Yağız Onur Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. , 2022, ss.747 - 754. 10.18621/eurj.872835
AMA	Yağız B,AKALIN A,Yorulmaz G,MACUNLUOĞLU A,Yağız O Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. . 2022; 747 - 754. 10.18621/eurj.872835
Vancouver	Yağız B,AKALIN A,Yorulmaz G,MACUNLUOĞLU A,Yağız O Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. . 2022; 747 - 754. 10.18621/eurj.872835
IEEE	Yağız B,AKALIN A,Yorulmaz G,MACUNLUOĞLU A,Yağız O "Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?." , ss.747 - 754, 2022. 10.18621/eurj.872835
ISNAD	Yağız, Burcu vd. "Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?". (2022), 747-754. https://doi.org/10.18621/eurj.872835

APA	Yağız B, AKALIN A, Yorulmaz G, MACUNLUOĞLU A, Yağız O (2022). Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. The European Research Journal, 8(6), 747 - 754. 10.18621/eurj.872835
Chicago	Yağız Burcu,AKALIN AYSEN,Yorulmaz Goknur,MACUNLUOĞLU Aslı Ceren,Yağız Onur Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. The European Research Journal 8, no.6 (2022): 747 - 754. 10.18621/eurj.872835
MLA	Yağız Burcu,AKALIN AYSEN,Yorulmaz Goknur,MACUNLUOĞLU Aslı Ceren,Yağız Onur Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. The European Research Journal, vol.8, no.6, 2022, ss.747 - 754. 10.18621/eurj.872835
AMA	Yağız B,AKALIN A,Yorulmaz G,MACUNLUOĞLU A,Yağız O Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. The European Research Journal. 2022; 8(6): 747 - 754. 10.18621/eurj.872835
Vancouver	Yağız B,AKALIN A,Yorulmaz G,MACUNLUOĞLU A,Yağız O Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?. The European Research Journal. 2022; 8(6): 747 - 754. 10.18621/eurj.872835
IEEE	Yağız B,AKALIN A,Yorulmaz G,MACUNLUOĞLU A,Yağız O "Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?." The European Research Journal, 8, ss.747 - 754, 2022. 10.18621/eurj.872835
ISNAD	Yağız, Burcu vd. "Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?". The European Research Journal 8/6 (2022), 747-754. https://doi.org/10.18621/eurj.872835