ECE2010 Poster Presentations Adrenal (66 abstracts)
Increased prevalence of metabolic syndrome in patients with subclinical autonomous cortisol hypersecretion by adrenal incidentalomas
Andromachi Vryonidou 1 , Dimitrios Ioannidis 2 , Evangelina Vassilatou 3 , Kostas Katsoulis 2 , Maria Panagou 2 , Kostas Panayiotopoulos 2 , Stamatina Michalopoulou 2 & Ioanna Tzavara 2
1Department of Endocrinology, Diabetes and Metabolism, Red Cross Hospital, Athens, Greece; 2Department of Endocrinology, Diabetes and Metabolism, ‘Amalia Fleming’ General Hospital, Athens, Greece; 3Endocrine Unit, Second Department of Internal Medicine, ‘Attikon’ University Hospital, Athens, Greece.
Background: Subclinical autonomous cortisol hypersecretion is the most common hormonal abnormality in patients with adrenal incidentalomas, which is characterized by subtle abnormalities of the hypothalamic–pituitary–adrenal axis (HPA) due to adrenal autonomy. Possible detrimental effects of subclinical hypercortisolism in these patients are still under investigation.
Objective: To investigate the prevalence of the metabolic syndrome (MS) in patients with adrenal incidentalomas.
Patients-methods: From a group of 194 patients with newly diagnosed adrenal incidentalomas by CT who were evaluated in our Departments, 121 patients under the age of 70 and without overt disease or a previous history of DM2 were studied for the presence of metabolic syndrome. All patients underwent a hormonal and biochemical evaluation. The diagnosis of subclinical Cushing’s syndrome was based on a post-LDDST plasma cortisol level ≥1.8 μg/dl combined with an abnormal result of at least one other test of the HPA axis and the absence of clinical signs of cortisol excess. The detection of MS was based on ATPIII criteria.
Results: Of 87 patients had a normal adrenal function (NF) and 33 had subclinical Cushing’s syndrome (SC). Patients with SC did not differ in clinical characteristics or the prevalence of hypertension from patients with NF, but had larger masses (3.1±1.0 vs 2.1±1.1 cm, P<0.01), higher fasting glucose (99.0±20.8 vs 92±14.4 mg/dl, P<0.05) and triglycerides levels (127.8±58 vs 107.3±42.4 mg/dl, P=0.037) than patients with NF. MS was more prevalent in patients with SC (15/33) than patients with NF (18/87) (45.4 vs 20.6%, P<0.01).
Conclusion: Patients with adrenal incidentalomas and subclinical autonomous cortisol hypersecretion have an increased prevalence of metabolic syndrome. These data support that even slight cortisol excess may have clinical implications but this needs to be clarified with prospective studies.
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Endocrine Abstracts
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