Endocrine Abstracts

JOINT955

Background: Although an association between adrenal adenomas and various cardiovascular and metabolic risk factors has previously been noted, it is suspected that patients with pre-existing comorbidities are more likely to be diagnosed with incidental adrenal adenomas due to increased frequency of imaging.

Methods: Historical case-control population study was performed. Patients diagnosed with adrenal adenoma between 2005-2017 with no evidence of overt hormone excess were paired with two different age- and sex-matched control groups without diagnosis of adrenal adenoma. To represent the general population, the first control group was randomly chosen from the same population matched on age and sex. The second control group only included patients who had a CT/MRI scan performed within 5 years prior to the index date (date of adrenal adenoma diagnosis). The prevalence of various social and metabolic risk factors present within 10 years prior to index date was compared across groups.

Results: Total of 670 cases identified. Patients with adrenal adenoma had a higher median body mass index (BMI) at 10 years prior to index date compared to the general population as well as the control group with prior imaging (30.1 kg/m² vs 27.4 kg/m² and 28.2 kg/m², respectively P<0.001). Cases were in a lower socioeconomic (SES) percentile based on Area Deprivation Index (ADI) at 10 years prior to index compared to controls (36.7% in poverty (ADI national percentage 51-100) vs 34.4% in the general population group and 31.1% in the control group with imaging, P=0.116). Compared to the general population control group, patients with adrenal adenoma were found to have higher prevalence of tobacco use, substance use, obesity, hypertension, dyslipidemia, pre-diabetes, and diabetes at 5-10 years prior to index date. However, when compared to the control group with prior cross-sectional imaging, the only differences that persisted were higher prevalence of obesity, tobacco use, and diabetes in patients with adrenal adenoma.

Conclusions: Previously noted associations between some cardiovascular/metabolic risk factors and adrenal adenomas are likely confounded by imaging bias. When compared to controls who had cross-sectional imaging performed within the past 10 years, patients with adrenal adenomas still had higher prevalence of obesity, tobacco use, and diabetes prior to index date.