Could a nonfunctional adrenal incidentaloma be a risk factor for increased carotid intima-media thickness and 10-year cardiovascular mortality based on the SCORE algorithm? A study from a single centre in Poland.

Endokrynologia Polska Pub Date : 2023-01-01 Epub Date: 2023-11-23 DOI:10.5603/ep.95139
Magdalena Szychlińska, Magdalena Rzeczkowska, Wojciech Matuszewski, Elżbieta Bandurska-Stankiewicz
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Abstract

Introduction: Adrenal incidentaloma (AI) secreting small amounts of glucocorticoids may cause morphological and functional changes in the blood vessels. Early stages of cardiovascular remodeling may be observed among asymptomatic patients with AI. But it is unclear whether the nonfunctional adrenal incidentalomas (NFAI) may also be a risk factor for cardiovascular diseases. The aim of this study was to determine the relationship between NFAI, carotid intima-media thickness (CIMT), and cardiovascular risk (CVR) based on Systematic Coronary Risk Evaluation (SCORE) prediction models for Europe.

Material and methods: This study from a single centre in Poland included 48 NFAI patients and 44 individuals in the control group matched for age, sex, and body mass index (BMI). All participants underwent adrenal imaging, biochemical evaluation, measurement of CIMT, and assessment of the 10-year risk of cardiovascular mortality based on the SCORE algorithm. Hormonal evaluation was conducted in AI patients.

Results: The NFAI group showed significantly higher sodium (p = 0.02) and glucose levels in the 2-h oral glucose tolerance test (OGTT) (p = 0.04), a higher CIMT (p < 0.01), and a higher CVR calculated according to the SCORE algorithm (p = 0.03). The estimated glomerular filtration rate (eGFR) was higher in the NFAI group (p = 0.015). Hypertension (p < 0.01) and IGT (p = 0.026) were more common in the NFAI group. Statistically significant positive correlations were found between CIMT and age (r = 0.373, p = 0.003), waist circumference (r = 0.316, p = 0.029), diastolic blood pressure (r = 0.338, p = 0.019), and CVR based on the SCORE algorithm (r = 0.43, p = 0.004). There was a statistically significant positive correlation between CIMT and serum cortisol levels after 1 mg dexamethasone suppression test (r = 0.33, p = 0.02).

Conclusion: Non-functional adrenal adenomas are associated with increased CIMT and CVR. Early stages of cardiovascular remodelling can be observed in asymptomatic NFAI patients.

基于SCORE算法,非功能性肾上腺偶发瘤可能是颈动脉内膜-中膜厚度增加和10年心血管死亡率增加的危险因素吗?一项来自波兰一个中心的研究。
肾上腺偶发瘤(AI)分泌少量糖皮质激素可引起血管形态和功能的改变。在无症状的AI患者中可观察到早期心血管重构。但目前尚不清楚非功能性肾上腺偶发瘤(NFAI)是否也可能是心血管疾病的危险因素。本研究的目的是基于欧洲的系统性冠状动脉风险评估(SCORE)预测模型,确定NFAI、颈动脉内膜-中膜厚度(CIMT)和心血管风险(CVR)之间的关系。材料和方法:本研究来自波兰的一个中心,包括48名NFAI患者和44名年龄、性别和体重指数(BMI)相匹配的对照组。所有参与者均接受肾上腺造影、生化评估、CIMT测量和基于SCORE算法的10年心血管死亡风险评估。对AI患者进行激素评价。结果:NFAI组在2 h口服糖耐量试验(OGTT)中钠(p = 0.02)和葡萄糖水平显著升高(p = 0.04), CIMT显著升高(p < 0.01), SCORE算法计算的CVR显著升高(p = 0.03)。NFAI组估计肾小球滤过率(eGFR)更高(p = 0.015)。NFAI组高血压(p < 0.01)和IGT (p = 0.026)发生率较高。CIMT与年龄(r = 0.373, p = 0.003)、腰围(r = 0.316, p = 0.029)、舒张压(r = 0.338, p = 0.019)、基于SCORE算法的CVR (r = 0.43, p = 0.004)呈正相关。1 mg地塞米松抑制试验后,CIMT与血清皮质醇水平呈正相关,差异有统计学意义(r = 0.33, p = 0.02)。结论:非功能性肾上腺腺瘤与CIMT和CVR升高相关。在无症状NFAI患者中可以观察到早期心血管重构。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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