Clinical Characteristics and Metabolic Features of Patients with Adrenal Incidentalomas with or without Subclinical Cushing's Syndrome

BACKGROUND: The aim of this study was to examine the clinical characteristics of adrenal incidentalomas discovered by computed tomography (CT) and to investigate metabolic features of subclinical Cushing's syndrome (SCS) in patients with adrenal incidentalomas in a tertiary hospital in Korea. METHODS: This retrospective study examined the clinical aspects of 268 patients with adrenal incidentalomas discovered by CT at Soonchunhyang University Bucheon Hospital. Clinical data and endocrine function of the patients as well as histological findings were obtained from medical records, while anatomic characteristics were analyzed by reviewing imaging studies. Hormonal tests for pheochromocytoma, Cushing's syndrome, and aldosterone-secreting adenoma were performed. RESULTS: Most (n=218, 81.3%) cases were nonfunctioning tumors. Of the 50 patients with functioning tumors (18.7%), 19 (7.1%) were diagnosed with SCS, nine (3.4%) with overt Cushing's syndrome, 12 (4.5%) with primary aldosteronism, and 10 (3.7%) with pheochromocytoma. Malignant tumors (both primary and metastatic) were rare (n=2, 0.7%). Body mass index, fasting glucose, hemoglobin A1c, and total cholesterol were significantly higher in patients with SCS in comparison with those with nonfunctioning tumors. The prevalence of type 2 diabetes mellitus and hypertension were significantly higher in patients with SCS compared with those with nonfunctioning tumors. CONCLUSION: Functioning tumors, especially those with subclinical cortisol excess, are commonly found in patients with adrenal incidentalomas, although malignancy is rare. In addition, patients with SCS in adrenal incidentalomas have adverse metabolic and cardiovascular profiles.

Reassessment of body mass index for screening obesity. Association of BMI and WHR with metabolic features in japanese women / 体力科学

In the present study, we investigated the associations of the body mass index (BMI ; kg/m<SUP>2</SUP>) and the waist to hip circumference ratio (WHR) with metabolic features in 134 Japanese women ranging in age from 24 to 79 years. We found that the BMI was reasonably well correlated with the WHR (r=0.693, p<0.001), which may be related to the health risk profile. The BMI and WHR both showed significant negative correlation with high-density lipoprotein cholesterol (HDL) level, and positive correlation with triglyceride (TG) and plasma glucose (GL) levels and systolic blood pressure (SBP) and diastolic blood pressure (DBP) . Following adjustment for the effect of the BMI, the partial correlation coefficients of WHR with HDL, TG, and GL were lower than those obtained before adjustment, and were not significant. However, the partial correlation coefficient of WHR with HDL/total cholesterol ratio (HDL/TC), SBP, and DBP were significant. These results suggest that the levels of HDL, TG and GL are associated with the BMI among subjects with similar WHR. We therefore propose that a combination of the BMI and WHR would be a superior indicator in obesity screening than the BMI alone.