Dyslipidemia in patients with adrenal incidentaloma with and without subclinical hypercortisolism and diabetes mellitus.
B. Masserini, V. Morelli, S. Palmieri, V. Zhukouskaya, E. Cairoli, C. Eller-Vainicher, E. Orsi, PBeck- Peccoz & I. Chiodini
Introduction: Patients with adrenal incidentalomas (AI) and subclinical hypercortisolism (SH) are thought to have increased incidence of cardiovascular risk factors, including diabetes mellitus (DM) and hypertension. Data regarding dyslipidemia are scarce. The aim of this study is to evaluate the possible influence of SH on lipid pattern in relation to the presence/absence of DM.
Methods and design: 276 AI patients were enrolled (168 F, 108 M), 55 with diabetes (AIDM+) and 221 without DM (AIDM−). As the presence of dyslipidemia is a common condition associated to DM, 83 age-, BMI- and gender-matched type 2 DM patients (CDM+) and 77 euglycemic subjects (CDM−) served as controls. SH was diagnosed in 49 patients in the presence of at least two out of these three parameters: cortisol levels after 1 mg dexamethasone suppression test >3 μg/dl, ACTH levels <10 pg/ml, and 24 h urinary free cortisol levels >70 μg/24 h. The prevalence of dyslipidemia was evaluated according to ATP III criteria. No subject was taking anti-dyslipidemic drugs.
Results: The prevalence of dyslipidemia tended to be higher, but not statistically significant, in AIDM+ in respect to CDM+ subjects (63.6 vs 54.2%, respectively, P=0.27), and was similar between AIDM− and CDM− (23.0 vs 20.8%, respectively, P=0.68). No difference was observed between AI patients with and without SH, in both DM and euglycemic groups. Considering the whole group of AI patients, the presence of dyslipidemia was associated with DM (OR 4.88, 95%CI 2.439.80, P=0.0001) and age (OR 1.03, 95%CI 1.001.06, P=0.047) and not with BMI (OR 1.02, 95%CI 0.961.08, P=0.55), and SH (OR 0.83, 95%CI 0.391.76, P=0.62).
Conclusions: In patients with adrenal incidentaloma, dyslipidemia seems to be associated to diabetes mellitus and not to subclinical hypercortisolism.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.