Introduction: Adrenal incidentalomas are frequent, their prevalence reaches 5% of the general population, incidental diagnosis from an imaging examination motivated by an extra-adrenal sign is common. Diabetes may be present in patients with adrenal incidentaloma, it is often diabetes secondary to secretion of cathecholamines, mineralocorticoids and cortisol.
Objective: To evaluate the clinical-biological profile of adrenal incidentalomas, as well as their association with diabetes.
Methods: Retrospective study of 40 cases of adrenal incidentaloma hospitalized between 20102018 in the endocrinology department. The epidemiological and clinico-biological profile of incidentalomas has been studied. Patients were compared in 2 groups according to presence (n=9) or no diabetes (n=31). Statistical analysis was univariate for all variables using SPSS software version 22.0.0.
Results: The prevalence of diabetes mellitus in patients with adrenal incidentalomas was found to be 22.5%. Diabetic patients followed were older than non-diabetics with an average age of 65 versus 52.9 years (P: 0.028) with female predominance. The majority of diabetics were at a very high cardiovascular risk with a hypertension significantly more frequent in the diabetic group (92% versus 44%) (P: 0.014) and dyslipidemia in 89% of cases versus 35% (P: 0.02). The metabolic syndrome was more common in diabetics: 84% versus 15% with an average BMI of 38.4 versus 23.6 kg/m2 (P: 0.015). It was a unilateral lesion in 30 patients and bilateral in 9 patients. The most common etiologies found in diabetics were: pheochromocytomas in 4 patients, metastasis in 1, adrenal carcinoma in 1, lymphoma in 1, one adrenal cyst and one myelolipoma. While in the control group the most frequent were benign adenomas in 18 cases, 8 pheochromocytomas, 2 Conn adenomas, 2 adrenal cysts and 1 myelolipoma.
Discussion: Our findings demonstrate a significantly higher risk of developing incident diabetes in individuals with adrenal incidentalomas.Their association is explained by a reduction in insulin sensitivity and the presence of other cardiovascular risk factors. The subclinical cushing syndrome is the most incriminated hence the interest of a cortisone dosage.
18 - 21 May 2019
European Society of Endocrinology