Nonfunctioning Adrenal Incidentaloma Associated With Metabolic Syndrome

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Patients were categorized by metabolic syndrome according to the WHO, NCEP-ATP III, AACE/ACE and IDF guidelines.
Patients were categorized by metabolic syndrome according to the WHO, NCEP-ATP III, AACE/ACE and IDF guidelines.

Individuals with nonfunctioning adrenal incidentaloma have more frequent cases of metabolic syndrome than those with normal adrenal imaging, according to a study published in Clinical Endocrinology. 

This retrospective transversal study included 74 individuals with nonfunctioning adrenal incidentaloma  and 90 controls selected for normal adrenal imaging. Between both groups, age, ethnicity, smoking, statin and fibrate use, gender, body mass index, and menopause status did not differ significantly. Participants with nonfunctioning adrenal incidentaloma had significantly higher rates of prediabetes, hypertension, dyslipidemia, and increased waist circumference than controls. 

In addition, the nonfunctioning adrenal incidentaloma group had a significantly higher frequency of metabolic syndrome  than those with normal adrenal function. Participants were categorized using definitions of metabolic syndrome in accordance with standards set forth by 4 different organizations. Their respective results were as follows: by criteria of the World Health Organization (WHO), 69.2% vs 31.0% (P <.001); American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE): 77.1% vs 31.9% (P <.001); International Diabetes Federation: 78.6% vs 45.5% (P <.001); and National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP II): 81.7% vs 44.9% (P <.001).

According to logistic regression analysis, NFAI proved to be an independent predictor for metabolic syndrome by the criteria of WHO (P =.001), AACE/ACE (P =.007), and NCEP-ATP III (P =.005).

Study researchers conclude that, "[metabolic] syndrome is frequently found in patients with [nonfunctioning adrenal incidentaloma], and this frequency is higher in [nonfunctioning adrenal incidentaloma] patients than in those with normal adrenal imaging."


Mello Ribeiro Cavalari E, de Paula MP, Arruda M, et al. Nonfunctioning adrenal incidentaloma: A novel predictive factor for metabolic syndrome [published online July 25, 2018]. Clin Endocrinol (Oxf). doi: 10.1111/cen.13822

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