Increased risk of unfavorable metabolic outcome during short-term follow-up in subjects with nonfunctioning adrenal adenomas

ABSTRACT

To demonstrate long-term changes in the prevalence of several types of metabolic derangements in subjects with nonfunctioning adrenal adenomas. 273 subjects with adrenal adenomas, including 231 with nonfunctioning adenoma and 42 with subclinical Cushing's syndrome [sCS], were evaluated with respect to anthropometric and laboratory characteristics and prevalence of type 2 diabetes mellitus [T2DM], hypertension, dys-lipidemia, metabolic syndrome [MS], prediabetes and cardiovascular disease [CVD]. Median duration was 24 months. Follow-up data of 114 participants with nonfunctioning adrenal adenomas are also presented while those of 117 were missing. Follow-up data regarding changes in anthropometric and laboratory parameters and prevalence rates of metabolic disturbances were obtained from the medical records. The prevalence rates for both patients with non-functioning adenoma and sCS were dyslipidemia 161 [59%], hypertension 147 [54%], MS 128 [47%], prediabetes 62 [23%], T2DM 49 [18%], and CVD 21 [8%]. Hypertension and CVD were prevalent in subjects with sCS compared to participants with nonfunctioning adenoma. In follow-up, body mass index [p = 0.005], systolic blood pressure [p < 0.001], waist circumference [p = 0.005], homeostasis model assessment [p = 0.046], high-sensitivity C-reactive protein [p =0.023], total cholesterol [p < 0.001] and low-density lipopro-tein cholesterol [p < 0.001] and prevalence of hypertension [p < 0.001], dyslipidemia [p < 0.001], prediabetes [p < 0.001] and MS [p < 0.01] significantly increased in subjects with nonfunctioning adenoma. The data showed that nonfunctioning adrenal adenomas were associated with the development or deterioration of atherosclerotic risk factors. Therefore, follow-up and management strategies should be developed to decrease atherosclerotic morbidity in those individuals