Glucose and lipid abnormalities in patients with adrenal incidentalomas

• Published in: Hellenic journal of nuclear medicine Vol. 22 Suppl 2; pp. 7 - 14
• Main Authors: Vukomanovic, V R, Ignjatovic, V D, Mihaljevic, O, Vuleta, K, Matovic, M D
• Format: Journal Article
• Language: English
• Published: Greece 01.09.2019
• Subjects: Adrenal Gland Neoplasms - blood; Adult; Aged; Cholesterol - blood; Cross-Sectional Studies; Cushing Syndrome - blood; Female; Glucose - metabolism; Humans; Hydrocortisone - blood; Hydrocortisone - metabolism; Incidental Findings; Insulin - blood; Lipids - blood; Male; Metabolic Diseases - blood; Middle Aged; Prospective Studies; Triglycerides - blood
• ISSN: 1790-5427

Adrenal incidentalomas (AI), defined as masses detected during imaging procedures of non-adrenal disorders, have become a common clinical problem that appear to have impairment of glucose and lipid metabolism. One hundred and ten patients (mean 53.5 age; 24-72), who were diagnosed with functioning and non-functioning AI, were assessed. Patients with hormone-secreting AI underwent biochemical evaluation regarding metabolic disorders. Data about hormone status (cortisol profile and DEX screening test), lipid profile, glycemia, insulinemia were evaluated. This prospective study included 41 (37.28%) patients with non-functional and 69 (62.72%) with functional AI. Tumors associated with (sub)clinical Cushing's syndrome (functional AI) are considered to have higher cortisol concentration at 8h (p=0.027), 16h (p=0.025) and after DEX screening (p<0.010), compared to the controls. Patients with cortisol-secreting AI have significantly higher concentrations of cholesterol (p=0.040), triglycerides (p=0.027) and insulin (p<0.01) than controls. The patients with metabolic disorders have a significantly higher total cholesterol, triglyceride and insulin concentration (p<0.001) compared to controls. There was significant positive correlation between cortisol concentration after DEX screening and total cholesterol (r=0.727, p=0.007), triglycerides (r=0.564, p=0.041) and insulin (r=0.957, p=0.043) in the group with metabolic disorders. The present study demonstrates the patients with functional AI have significantly higher lipid, glucose and insulin concentration than controls. There was a significant positive correlation between metabolic parameters and cortisol concentration.