Glycemic Risk Index in a Cohort of Patients with Type 1 Diabetes Mellitus Stratified by the Coefficient of Variation: A Real-Life Study.

Objective: To analyze the Glycemic Risk Index (GRI) and assess their possible differences according to coefficient of variation (CV) in a cohort of real-life type 1 diabetes mellitus (DM) patient users of intermittently scanned continuous glucose monitoring (isCGM). Patients and Methods: In total, 447 adult users of isCGM with an adherence ≥70% were included in a cross-sectional study. GRI was calculated with its hypoglycemia (CHypo) and hyperglycemia (CHyper) components. Multivariate linear regression analysis was performed to evaluate the factors associated with GRI. Results: Mean age was 44.6 years (standard deviation [SD] 13.7), 57.7% being male; age of DM onset was 24.5 years (SD 14.3) and time of evolution was 20.6 years (SD 12.3). In patients with CV >36% (52.8%) versus CV ≤36% (47.2%), differences were observed in relation to GRI (18.8% [SD 1.9]; P < 0.001), CHypo (2.9% [SD 0.3]; P < 0.001), CHyper (6.3% [SD 1.4]; P < 0.001), and all classical glucometric parameters except time above range level 1. The variables that were independently associated with GRI in patient with CV >36% were time in range (TIR) (ß = -1.49; confidence interval [CI:] 95% -1.63 to -1.37; P < 0.001), glucose management indicator (GMI) (ß = -7.22; CI: 95% -9.53 to -4.91; P < 0.001), and CV (ß = 0.85; CI: 95% 0.69 to 1.02; P < 0.001). However, in patients with CV ≤36%, the variables were age (ß = 0.15; CI: 95% 0.03 to 0.28; P = 0.019), age of onset (ß = -0.15; CI: 95% -0.28 to -0.02; P = 0.023), TIR (ß = -1.35; CI: 95% -1.46 to -1.23; P < 0.001), GMI (ß = -6.67; CI: 95% -9.18 to -4.15; P < 0.001), and CV (ß = 0.33; CI: 95% 0.11 to 0.56; P = 0.004). Conclusions: In this study, the factors independently associated with metabolic control according to GRI are modified by glycemic variability.

Factors associated with Glycemia Risk Index in a cohort of patients with type 1 Diabetes Mellitus and Latent Autoimmune Diabetes In Adults (LADA).

OBJECTIVE: To analyze the degree of control based on classical glucometric parameters and Glycemia Risk Index (GRI) in real-life conditions in a cohort of patients with type 1 Diabetes Mellitus (DM) and Latent Autoimmune Diabetes in Adults (LADA) and to assess the factors that are associated with GRI. PATIENTS AND METHODS: Cross-sectional study. 447 adult patients with type 1 DM and LADA users of Intermittent Continuous Glucose Monitoring (iCGM) with an adherence ≥ 70% were included. GRI was calculated with its Hypoglycemia (CHypo) and Hyperglycemia (CHyper) Components. Multivariate linear regression analysis was performed to evaluate the factors associated with GRI. RESULTS: Mean age 44.6 years (SD 13.7); 57.7% men; 83.9% type 1 DM; 16.1% LADA; time of evolution 20.6 years (SD 12.3). In patients with type 1 DM vs. LADA, differences were observed in relation to age [-11.1 years (SD 1.7)], age of onset [-21.9 years (DE 1.5)], time of evolution [11.7 years (DE 1.5)], treatment modality (p < 0.001), Time in Range (TIR) [-6.3% (SD 2.2)], Time Below Range (TBR) [1.9% (SD 0.6)], TBR level 1 (TBR1) [1.4% (SD 0.5)], Time Above Range (TAR) level 2 (TAR2) [4.7% (SD 1.3)], Coefficient of Variation (CV) [4.6% (SD 0.9)], GRI [11.3% (SD 2.8)], CHypo [1.3% (SD 0.5)] and CHyper [4.8% (SD 1.7)]. The variables that were independently associated with GRI were TIR (ß = -1.34; CI 95% -1.43 to -1.25; p < 0.001), Glucose Management Indicator (GMI) (ß = -5.82; CI 95% -7.59 to -4.05; p < 0.001), CV (ß = 0.67; CI 95% 0.57 to 0.77; p < 0.001) and adherence to sensor usage (ß = -0.16; CI 95% -1.27 to -0.06; p < 0.002). CONCLUSIONS: LADA present better control according to some glucometric parameters and a low GRI. However, the type of DM is not a factor that is independently associated with GRI.

Malnutrition risk prevalence in hospitalised patients in Castilla-La Mancha: Ten years after the PREDyCES® study.

INTRODUCTION: The PREDyCESR study showed ten years ago that malnutrition is a highly prevalent problem at the hospital level. In the present study we investigate the prevalence of malnutrition in hospitals of Castilla La Mancha and its relationship with complications, mortality and length of hospital stay. METHODS: 433 patients (236 men and 197 women), from 4 hospitals were included and randomised within the first 48 h of admission. Nutritional risk was assessed using the NRS-2002 screening test. RESULTS: The mean age of the patients was 71.3 ±â€¯0.9 years (alpha-trimmed mean ±â€¯insorized standard deviation). Their mean weight was 72.3 ±â€¯0.8 kg and BMI 26.8 ±â€¯0.3 kg/m2. The mean length of hospital stay was 7.2 ±â€¯0.3 days. Of the 433 study patients, 19.4% were defined as 'at-risk' by NRS-2002 > 3. Of the patients at risk, 39.3% received nutritional support. Patients at nutritional risk had an increased length of hospital stay (9.6 vs 6.8 days; p = 0.012) and had more complications and/or higher mortality (40.5% of complications and/or mortality vs 16.4%; p < 0.005). The OR of having a complication and/or death was 3.93 (95% CI: 2.36-6.5); p < 0.005. Regarding the results obtained in the PREDyCES® study, no significant differences were found in the prevalence of nutritional risk at patients' admission (19.4% vs 23%; p = 0.12). CONCLUSIONS: The nutritional risk at hospital admission continues to be high. Patients at nutritional risk have more complications, higher mortality and an increased length of hospital stay.

Neoplasia endocrina múltiple tipo 1 y cáncer de mama. Una asociación a tener en cuenta / Multiple endocrine neoplasia type 1 and breast cancer. An association to consider

No disponible

Evolución clínica de una cohorte de pacientes con diabetes mellitus tipo 2 tras su valoración en endocrinología. Estudio a 26 semanas / Clinical course of a cohort with type 2 diabetes mellitus after endocrine assessment. A 26-week study

Objetivo: Evaluar el grado de control metabólico y los tratamientos hipoglucemiantes en una cohorte de pacientes con diabetes mellitus tipo 2 (DM2) tras su valoración en endocrinología. Material y métodos: Estudio de cohortes prospectivo. Se incluyeron 465 pacientes con DM2 que no realizaban seguimiento en una consulta de endocrinología. Se recogieron datos de control glucémico y tratamientos recibidos en una visita inicial y tras 26 semanas de seguimiento. Resultados: La hemoglobina glucosilada (HbA1c) inicial fue de 8,3±1,8%, mientras que tras 26 semanas de seguimiento fue de 6,6±0,9% (p<0,0001). El porcentaje de pacientes con HbA1c<7% ascendió de 33,1 a 71,3% (p<0,0001). En el 59,9% de los pacientes se observó un descenso ≥0,8% de HbA1c. En el análisis multivariante, las variables que predijeron una mejoría en el grado de control metabólico fueron una mayor edad (OR 1,038; IC 95%: 1-1,07; p=0,041), una mayor HbA1c inicial (OR 5,51; IC 95%: 3,4-9; p<0,0001), un tiempo de evolución de la DM2<5 años (OR 4,63; IC 95%: 1,6-13,3; p=0,005) y el cambio de tratamiento hipoglucemiante (OR 2,77; IC 95%: 1,1-6,9; p=0,03). En el 75,1% de los sujetos con DM2 incluidos en el estudio se modificó el tratamiento hipoglucemiante. El porcentaje de pacientes que no recibía tratamiento disminuyó del 7% al 0,3% tras 26 semanas de seguimiento (p<0,0001), así como el porcentaje de pacientes que recibía tratamiento con antidiabéticos orales (60,9 vs 55,5%) (p=0,003) e insulina (10,5 vs 6,2%) (p=0,021). Sin embargo, aumentó el porcentaje de pacientes que recibían tratamiento con insulina combinada con antidiabéticos orales de 21,1% a 38% (p<0,0001). Conclusiones: se produce una mejoría del control metabólico en esta cohorte de pacientes con DM2 tras su valoración en una consulta de endocrinología. No obstante, en el 28,7% no se alcanza un HbA1c<7%, lo que pone de manifiesto la dificultad en conseguir un buen control en la práctica clínica (AU)

Objective: To assess the degree of metabolic control and hypoglycemic treatments in a cohort of patients with type 2 diabetes mellitus (T2DM) after evaluation in an endocrinology clinic. Material and methods: A prospective cohort study on 465 patients with T2DM who were not being monitored at an endocrinology clinic. Blood glucose control data and treatments received were recorded at an initial visit and after 26 weeks of follow-up. Results: Baseline glycosylated hemoglobin (HbA1c) level was 8.3±1.8%, as compared to 6.6±0.9% after 26 weeks of follow-up (P<.0001). The proportion of patients with HbA1c levels <7% increased from 33.1% to 71.3% (P<.0001). In 59.9% of patients, a decrease ≥0.8% in HbA1c was seen. In the multivariate analysis, variables predicting for an improvement in the degree of metabolic control were older age (OR 1.038; 95%CI 1-1.07; P=.041), higher baseline HbA1c values (OR 5.51; 95%CI 3.4-9; P<.0001), T2DM duration <5 years (OR 4.63; 95%CI 1.6-13.3; P=.005), and change in hypoglycemic treatment (OR 2.77, 95%CI 1.1-6.9; P=.03). Hypoglycemic therapy was changed in 75.1% of study patients with T2DM. After 26 weeks of follow-up, decreases were seen in both the proportion of patients who receiveding no treatment (from 7% to 0.3%, P<.0001) and the proportions of patients on oral antidiabetic therapy (60.9% vs 55.5%, P=.003) and insulin (10.5% vs 6.2%, P=.021). However, the proportion of patients receiving insulin combined with oral antidiabetic drugs increased from 21.1% to 38% (P<.0001). Conclusions: An improved metabolic control was seen in this cohort of patients with T2DM after their evaluation in an endocrinology clinic. However, HbA1c levels <7% were not achieved in 28.7% of patients, which shows the difficulty to achieve adequate control in clinical practice (AU)

Clinical course of a cohort with type 2 diabetes mellitus after endocrine assessment. A 26-week study. / Evolución clínica de una cohorte de pacientes con diabetes mellitus tipo 2 tras su valoración en endocrinología. Estudio a 26 semanas.

OBJECTIVE: To assess the degree of metabolic control and hypoglycemic treatments in a cohort of patients with type 2 diabetes mellitus (T2DM) after evaluation in an endocrinology clinic. MATERIAL AND METHODS: A prospective cohort study on 465 patients with T2DM who were not being monitored at an endocrinology clinic. Blood glucose control data and treatments received were recorded at an initial visit and after 26 weeks of follow-up. RESULTS: Baseline glycosylated hemoglobin (HbA1c) level was 8.3±1.8%, as compared to 6.6±0.9% after 26 weeks of follow-up (P<.0001). The proportion of patients with HbA1c levels <7% increased from 33.1% to 71.3% (P<.0001). In 59.9% of patients, a decrease ≥0.8% in HbA1c was seen. In the multivariate analysis, variables predicting for an improvement in the degree of metabolic control were older age (OR 1.038; 95%CI 1-1.07; P=.041), higher baseline HbA1c values (OR 5.51; 95%CI 3.4-9; P<.0001), T2DM duration <5 years (OR 4.63; 95%CI 1.6-13.3; P=.005), and change in hypoglycemic treatment (OR 2.77, 95%CI 1.1-6.9; P=.03). Hypoglycemic therapy was changed in 75.1% of study patients with T2DM. After 26 weeks of follow-up, decreases were seen in both the proportion of patients who receiveding no treatment (from 7% to 0.3%, P<.0001) and the proportions of patients on oral antidiabetic therapy (60.9% vs 55.5%, P=.003) and insulin (10.5% vs 6.2%, P=.021). However, the proportion of patients receiving insulin combined with oral antidiabetic drugs increased from 21.1% to 38% (P<.0001). CONCLUSIONS: An improved metabolic control was seen in this cohort of patients with T2DM after their evaluation in an endocrinology clinic. However, HbA1c levels <7% were not achieved in 28.7% of patients, which shows the difficulty to achieve adequate control in clinical practice.

Soporte nutricional con nutrición parenteral. Evolución y complicaciones asociadas / Nutritional support with parenteral nutrition. Course and associated complications

Introducción La nutrición parenteral (NP) es una parte integral del tratamiento médico de aquellos pacientes que no tienen un tracto gastrointestinal funcionante o accesible. En este trabajo se describen las características clínicas de los pacientes que han recibido NP en un hospital de 420 camas desde 2009 hasta 2011. Además, se evaluaron los parámetros nutricionales al inicio y fin de la NP, y se analizaron las complicaciones asociadas. Material y métodos Estudio observacional retrospectivo de los episodios de NP en mayores de 18 años seguidos por la Unidad de Nutrición del Hospital Universitario de Guadalajara. Se recogieron: datos epidemiológicos y clínicos, número y tipo de vías empleadas, datos antropométricos, datos analíticos, número de días con NP, causa de la retirada, aporte calórico, prevalencia de flebitis, complicaciones metabólicas (hipertrigliceridemia, alteraciones en las pruebas de función hepática, hiperglucemia y síndrome de realimentación) y prevalencia de bacteriemia asociada a catéter venoso central (BAC).Resultados Se registraron 312 episodios de NP. La indicación inmediata fue íleo posquirúrgico en el 53,8% de los episodios. Se produjo una mejoría estadísticamente significativa de todos los parámetros analíticos que se evaluaron (albúmina, prealbúmina, proteína transportadora de retinol, transferrina, colesterol y linfocitos). El aporte calórico (Kcal por kg de peso) fue de 25,1 ± 6,6. En el 16,3% de los episodios no se registró ninguna complicación (..) (AU)

Introduction Parenteral nutrition (PN) is an integral part of medical management of patients who do not have a functioning or accessible gastrointestinal tract. This paper discusses the clinical characteristics of patients receiving PN in a 420-bed hospital from 2009 to 2011. In addition, nutritional parameters were assessed at the start and end of PN and associated complications were analyzed. Material and methods retrospective, observational study of PN episodes in adults conducted at the Nutrition Unit of Hospital Universitario de Guadalajara. Variables collected included epidemiological and clinical data, number and type of routes used, anthropometric data, analytical data, number of days on PN, reason for withdrawal, caloric provision, prevalence of phlebitis, metabolic complications (hypertriglyceridemia, abnormal liver function tests, hyperglycemia, and refeeding syndrome), and prevalence of bacteremia associated with central venous catheter (BAC).Results There were 312 episodes of PN. The immediate indication was postoperative ileus in 53.8% of the episodes. There was a statistically significant improvement in all analytical parameters assessed (albumin, prealbumin, retinol binding protein, transferrin, cholesterol, and lymphocytes). Caloric provision (kcal per kg) was 25.1 ± 6.6. No metabolic complication occurred in 16.3% of the episodes, and hyperglycemia was the most common complication (79.8%). There were 10 cases of phlebitis (32.2%) and 30 episodes of BAC (8.7%). Bacteriemia rate was 8.1 per 1000 days of PN. Discussion Although PN is an effective nutritional support technique, it is associated with complications of varying severity. Use of PN should therefore comply with the instructions accepted in the main clinical practice guidelines and requires careful monitoring by experienced professionals (AU)

[Nutritional support with parenteral nutrition. Course and associated complications]. / Soporte nutricional con nutrición parenteral. Evolución y complicaciones asociadas.

INTRODUCTION: Parenteral nutrition (PN) is an integral part of medical management of patients who do not have a functioning or accessible gastrointestinal tract. This paper discusses the clinical characteristics of patients receiving PN in a 420-bed hospital from 2009 to 2011. In addition, nutritional parameters were assessed at the start and end of PN and associated complications were analyzed. MATERIAL AND METHODS: retrospective, observational study of PN episodes in adults conducted at the Nutrition Unit of Hospital Universitario de Guadalajara. Variables collected included epidemiological and clinical data, number and type of routes used, anthropometric data, analytical data, number of days on PN, reason for withdrawal, caloric provision, prevalence of phlebitis, metabolic complications (hypertriglyceridemia, abnormal liver function tests, hyperglycemia, and refeeding syndrome), and prevalence of bacteremia associated with central venous catheter (BAC). RESULTS: There were 312 episodes of PN. The immediate indication was postoperative ileus in 53.8% of the episodes. There was a statistically significant improvement in all analytical parameters assessed (albumin, prealbumin, retinol binding protein, transferrin, cholesterol, and lymphocytes). Caloric provision (kcal per kg) was 25.1±6.6. No metabolic complication occurred in 16.3% of the episodes, and hyperglycemia was the most common complication (79.8%). There were 10 cases of phlebitis (32.2%) and 30 episodes of BAC (8.7%). Bacteriemia rate was 8.1 per 1000 days of PN. DISCUSSION: Although PN is an effective nutritional support technique, it is associated with complications of varying severity. Use of PN should therefore comply with the instructions accepted in the main clinical practice guidelines and requires careful monitoring by experienced professionals.

Concentraciones deficientes de vitamina D en pacientes con obesidad mórbida. Estudio de caso-control / Vitamin D deficiency in morbidly obese patients. A case-control study

Objetivos Estudios recientes muestran una elevada prevalencia de déficit de vitamina D en la población general, sobre todo en pacientes ancianos. También existen estudios que describen esta misma situación en los sujetos con obesidad mórbida (OM), aunque en pocos se compara a sujetos con OM y sin obesidad. Los objetivos de este estudio fueron estimar la prevalencia de déficit de vitamina D e hiperparatiroidismo secundario en ambos grupos y valorar si existe relación entre OM y deficiencia de vitamina D. Métodos El estudio se realizó en el Hospital Universitario de Guadalajara (España), desde diciembre de 2008 hasta diciembre de 2009, obteniéndose los datos de 138 sujetos. El 50,7% presentaba OM y el 49,3% no presentaba obesidad. En ambos grupos se obtuvo una muestra de sangre en ayunas para la determinación de 25-hidroxivitamina D, paratirina intacta, calcio, albúmina y fósforo, entre otros constituyentes bioquímicos. Resultados En el grupo de sujetos con OM, la concentración media de 25-hidroxivitamina D fue de 16,6±8,12ng/ml, mientras que en el grupo de sujetos sin obesidad fue de 21,9±7,34ng/ml (p<0,0001). El déficit de vitamina D fue del 80% en el grupo de pacientes con OM y del 41% en los sujetos sin obesidad (p<0,0001). No se obtuvieron diferencias estadísticamente significativas en las concentraciones de paratirina intacta, calcio y fósforo entre ambos grupos. Conclusiones Se confirma la elevada prevalencia de deficiencia de vitamina D en los grupos estudiados, aunque la concentración de 25-hidroxivitamina D fue significativamente menor en los sujetos con OM. La OM es un factor asociado a que exista déficit de vitamina D, por lo que podría valorarse incluir la determinación de 25-hidroxivitamina D en las guías para el manejo de los pacientes con OM con el fin de evitar estados carenciales (AU)

Objectives Recent studies show a high prevalence of vitamin D deficiency in the general population, especially in the elderly. There are also studies reporting the same observations in the morbidly obese, although few of these studies have compared morbidly obese individuals with non-obese persons. The objectives of this study were to estimate the prevalence of vitamin D deficiency and secondary hyperparathyroidism in both groups and to assess whether there is a relationship between obesity and vitamin D deficiency. Methods This study was carried out in 138 patients in the Guadalajara University Hospital (Spain) between December 2008 and December 2009. Of these, 50.7% were morbidly obese and 49.3% were not obese. Fasting blood samples were taken from both groups for determination of 25-hydroxyvitamin D, intact parathyroid hormone, calcium, albumin and phosphorus, among other biochemical parameters. Results The mean concentration of 25-hydroxyvitamin D was 16.6±8.12ng/ml in the morbidly obese group and 21.9±7.34ng/ml in the non-obese group (p<0.0001). The prevalence of vitamin D deficiency was 80% in morbidly obese patients and 41% in non-obese patients (p<0.0001). There were no statistically significant differences in concentrations of parathyroid hormone, calcium or phosphorus between the two groups. Conclusions A high prevalence of vitamin D deficiency was found in both groups studied, although the concentration of 25-hydroxyvitamin D was significantly lower in the morbidly obese. Morbid obesity is closely linked to vitamin D deficiency. To prevent this deficiency, determination of 25-hydroxyvitamin D should be included in clinical practice guidelines for the treatment of obesity (AU)

[Vitamin D deficiency in morbidly obese patients. A case-control study]. / Concentraciones deficientes de vitamina D en pacientes con obesidad mórbida. Estudio de caso-control.

OBJECTIVES: Recent studies show a high prevalence of vitamin D deficiency in the general population, especially in the elderly. There are also studies reporting the same observations in the morbidly obese, although few of these studies have compared morbidly obese individuals with non-obese persons. The objectives of this study were to estimate the prevalence of vitamin D deficiency and secondary hyperparathyroidism in both groups and to assess whether there is a relationship between obesity and vitamin D deficiency. METHODS: This study was carried out in 138 patients in the Guadalajara University Hospital (Spain) between December 2008 and December 2009. Of these, 50.7% were morbidly obese and 49.3% were not obese. Fasting blood samples were taken from both groups for determination of 25-hydroxyvitamin D, intact parathyroid hormone, calcium, albumin and phosphorus, among other biochemical parameters. RESULTS: The mean concentration of 25-hydroxyvitamin D was 16.6+/-8.12 ng/ml in the morbidly obese group and 21.9+/-7.34 ng/ml in the non-obese group (p<0.0001). The prevalence of vitamin D deficiency was 80% in morbidly obese patients and 41% in non-obese patients (p<0.0001). There were no statistically significant differences in concentrations of parathyroid hormone, calcium or phosphorus between the two groups. CONCLUSIONS: A high prevalence of vitamin D deficiency was found in both groups studied, although the concentration of 25-hydroxyvitamin D was significantly lower in the morbidly obese. Morbid obesity is closely linked to vitamin D deficiency. To prevent this deficiency, determination of 25-hydroxyvitamin D should be included in clinical practice guidelines for the treatment of obesity.

Incidentalomas suprarrenales: experiencia clínica en los hospitales de Castilla-La Mancha / Adrenal incidentalomas: clinical experience in the hospitals of Castilla-La Mancha (Spain)

Objetivo: El manejo de las masas suprarrenales descubiertas de manera incidental (incidentalomas) sigue siendo controvertido. El objetivo de este trabajo es describir las características demográficas y clínicas, así como el manejo diagnóstico-terapéutico, de una serie de pacientes conincidentalomas suprarrenales atendidos en los principales hospitales de Castilla-La Mancha. Material y métodos: Los datos se recogieron mediante revisión de historias clínicas. Resultados: Se revisaron las historias clínicas de 270 pacientes(el 28,1% de Toledo, el 25,9% de Albacete, el 24,1% de Ciudad Real, el15,9% de Cuenca y el 5,9% de Guadalajara), con media de edad de60,3 ± 12 años y de los que el 53,3% eran mujeres. El 80,6% presentaba sobrepeso u obesidad; el 55,8%, hipertensión arterial; el 25,6%, diabetes mellitus; el 15,6%, alteración de la glucemia en ayunas o intolerancia hidrocarbonada; el 31,5%, osteopenia, y el 20,4%, osteoporosis; estos porcentajes son similares en los pacientes con síndrome de Cushing subclínico. El 66% de los tumores medían menos de 3 cm y el 14,3% más de 4 cm. El 85% fueron detectados por tomografía computarizada. Tras una mediana de seguimiento de 28,8 meses el 6% de los adenomas no funcionantes evolucionaron a un síndrome de Cushing subclínico, en un9,4% de los casos el diámetro de la masa aumentó más de 1 cm y en un8,9% apareció una masa contralateral. El 14,4% de los pacientes se sometieron a suprarrenalectomía quirúrgica. Conclusiones: Nuestro estudio confirma la evolución favorable de la mayoría de los pacientes con incidentalomas suprarrenales y contribuye a un mejor conocimiento de esta entidad clínica (AU)

Objective: The management of incidentally discovered adrenal masses (incidentalomas) remains controversial. Our objective was to describe the demographic and clinical characteristics of a series of patients with adrenal incidentalomas attended in several hospitals of Castilla-La Mancha, and their diagnostic and therapeutic management. Material and methods: Data were obtained by reviewing the patients’ medical charts. Results: A total of 270 patients were included (28.1% from Toledo, 25.9% from Albacete, 24.1% from Ciudad Real, 15.9% from Cuenca and 5.9% from Guadalajara). The mean age was 60.3 ± 12 and 53.3% were women. Overweight or obesity were found in 80.6%, hypertension in 55.8%, diabetes mellitus in 25.6%, impaired fasting glucose or impaired glucose tolerance in 15.6%, osteopenia in 31.5% and osteoporosis in 20.4%. These percentages were similar in patients with subclinical Cushing’s syndrome. Diameter was less than 3 cm in 66% of the tumors, and more than 4 cm in 14.3%. Eighty-five percent of the tumors were detected by computed tomography. After a median follow-up of 28.8 months, 6% of non-functioning adenomas progressed to subclinical Cushing’s syndrome, tumoral enlargement of more than 1 cm was found in 9.4% and a contralateral mass developed in 8.9%. Surgical adrenalectomy was performed in 14.4% of the patients. Conclusions: Our study confirms the favorable outcome in most patients with adrenal incidentalomas and contributes to a better understanding of this clinical entity (AU)