Endocrine Abstracts

JOINT2999

Introductıon: Pheochromocytoma (PHEO) is a rare tumor characterized by excessive release of catecholamines. Although improvements in metabolic parameters are observed after surgery, the relationship between serum catecholamine levels and these changes has not been thoroughly investigated. The aim of this study was to evaluate the changes in metabolic parameters, cardiovascular risk and hepatic fibrosis in patients with PHEO and non-functioning adrenal masses (NFA) after adrenalectomy and the relationship between these changes and preoperative catecholamine levels.

Methods: Between 2019 and 2024, patients with PHEO and NFA (adenoma or hyperplasia) who were admitted to the Endocrinology and Metabolic Diseases Clinic of Ankara City Hospital and underwent adrenalectomy were included in the study. Pre- and post-adrenalectomy measurements of glucose, biochemistry, hemogram, lipids, insulin, HbA1c, systolic and diastolic blood pressures, weight and BMI were recorded and compared. Preoperative serum and 24-hour urine catecholamine levels were recorded. We used the SCORE calculation model recommended by the Endocrinology and Metabolism Society of Turkey for cardiovascular risk prediction in Turkey (7). For liver fibrosis assessment, we used the Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS), AST to Platelet Ratio Index (APRI) and Fibrosis 4 (FIB-4) scores (10–12). Changes in metabolic parameters, cardiovascular risk scores and hepatic fibrosis scores were analyzed and the associations between preoperative catecholamine levels and these parameters were evaluated.

Results: In this study, 61 pheochromocytoma (PHEO) and 37 non-functioning adenoma (NFA) patients who underwent adrenalectomy were evaluated. HbA1c (P<0.001), HDL levels (P=0.007), systolic and diastolic blood pressure (P<0.001) and SCORE cardiovascular risk (P=0.001) decreased after adrenalectomy in PHEO patients, while triglyceride levels increased (P=0.057). Postoperative NFS score was significantly elevated in PHEO (P=0.03). A negative correlation was found between preoperative systolic and diastolic blood pressure and preoperative urinary dopamine in PHEO (P=0.041, P=0.045, respectively). A negative correlation was also found between preoperative urinary dopamine levels and preoperative FIB-4 (r=−0.373, P=0.021) and NFS (r=−0.358, P=0.038), as well as between urinary metanephrine levels and APRI score (r=−0.286, P=0.03). Preoperative urinary metanephrine levels were higher in patients whose FIB-4 score did not improve (P=0.25).

Conclusıons: The reduced SCORE and blood pressure after surgery in patients with PHEO suggest that early diagnosis and surgery play a critical role in reducing cardiovasculer mortality and morbidity. Preoperative elevated catecholamine levels may have a protective effect on liver fibrosis and it will be important to confirm these findings with new studies for long-term follow-up.