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Could a nonfunctional adrenal incidentaloma be a risk factor for increased carotid intima-media thickness and metabolic syndrome / ¿Puede ser un incidentaloma suprarrenal no funcional un factor de riesgo de aumento del grosor íntima-media carotídeo y de síndrome metabólico?
Emral, Rıfat; Aydoğan, Berna İmge; Köse, Ayla Demir; Demir, Özgür; Çorapçıoğlu, Demet.
Afiliação
  • Emral, Rıfat; Ankara University Faculty of Medicine. Department of Endocrinology and Metabolic Diseases. Ankara. Turkey
  • Aydoğan, Berna İmge; Ankara University Faculty of Medicine. Department of Endocrinology and Metabolic Diseases. Ankara. Turkey
  • Köse, Ayla Demir; Ankara University Faculty of Medicine. Department of Endocrinology and Metabolic Diseases. Ankara. Turkey
  • Demir, Özgür; Ankara University Faculty of Medicine. Department of Endocrinology and Metabolic Diseases. Ankara. Turkey
  • Çorapçıoğlu, Demet; Ankara University Faculty of Medicine. Department of Endocrinology and Metabolic Diseases. Ankara. Turkey
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(7): 402-409, ago.-sept. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-182859
Biblioteca responsável: ES1.1
Localização: BNCS
ABSTRACT

Background:

This study was designed to detect the potential association of a nonfunctional adrenal incidentaloma (NFAI) with insulin resistance and associated metabolic disturbances, with a subsequent increase in cardiovascular risk factors.

Methods:

Eighty-three NFAI patients and 56 volunteers (controls) without any adrenal abnormalities on computed tomography (CT) were included. Fasting blood glucose (FBG), fasting insulin, lipid profiles, uric acid, homocysteine, fibrinogen, high sensitivity C-reactive protein (hs-CRP), and adiponectin levels were measured in both groups. Blood pressure (BP), waist circumference, body mass index (BMI), and carotid intima media thickness (CIMT) were evaluated in both the patients and volunteers.

Results:

There were no significant difference between the NFAI and control groups with respect to age, sex, BMI, waist circumference, systolic and diastolic BP, smoking, concomitant disease, and medications. Fasting insulin and glucose levels and homeostasis model of assessment-insulin resistance (HOMA-IR) scores were significantly higher in the NFAI group as compared with those in the control group (p<0.01). The frequency of metabolic syndrome in the NFAI group was higher than that in the control group (p<0.01). All the lipid fractions, except triglyceride (TG), (p<0.05), homocysteine (p=0.01), and fibrinogen levels (p<0.001), were significantly higher in the NFAI group as compared with the levels in the control group. There were no significant differences between the NFAI and control groups in terms of uric acid, hs-CRP, and adiponectin levels. The CIMT values in the NFAI group were significantly higher than those in the control group (0.74±0.14 vs. 0.53±0.09, p<0.001). The mean CIMT value showed a statistically positive correlation with age (r=0.245, p=0.004); the HOMA-IR score (r=0.490, p<0.001); and FBG (r=0.521, p<0.001), fasting insulin (r=0.432, p<0.001), total cholesterol (TC) (r=0.267, p=0.002), and fibrinogen (r=0.398, p<0.001) levels in the NFAI group.

Conclusions:

The results indicated that the NFAI patients had an elevated risk of insulin resistance, with metabolic syndrome and increased CIMT values. Long-term follow-up studies should be designed to evaluate postsurgical alterations in metabolic parameters and cardiovascular risk factors in NFAI patients
RESUMEN
Antecedentes Este estudio se diseñó para detectar la posible asociación del incidentaloma suprarrenal no funcionante (ISNF) con resistencia a la insulina y trastornos metabólicos asociados, con un incremento subsecuente en los factores de riesgo cardiovascular.

Métodos:

Se incluyó a 83 pacientes con ISNF y a 56 voluntarios (controles) sin anomalías suprarrenales en la tomografía computarizada (TC). Se determinaron en ambos grupos los valores de glucemia en ayunas (GA), insulina en ayunas, perfiles lipídicos, ácido úrico, homocisteína, fibrinógeno, proteína C reactiva de alta sensibilidad (PCRas) y adiponectina. Se evaluaron la presión arterial (PA), el perímetro de la cintura, el índice de masa corporal (IMC) y el grosor íntima-media carotídea (GIMC) tanto en los pacientes como en los voluntarios.

Resultados:

No había una diferencia significativa entre los grupos con ISNF y de control en cuanto a edad, sexo, IMC, perímetro de la cintura, PA sistólica y diastólica, tabaquismo, enfermedades concomitantes y medicamentos. Las concentraciones de insulina y glucosa en ayunas y las puntuaciones del modelo homeostático de evaluación de la resistencia a la insulina (HOMA-IR) fueron significativamente mayores en el grupo con ISNF que en el de control (p<0,01). La frecuencia de síndrome metabólico fue mayor en el grupo con ISNF que en el de control (p<0,01). Los valores de todas las fracciones lipídicas, excepto los de triglicéridos (TG) (p<0,05), homocisteína (p=0,01) y fibrinógeno (p<0,001), fueron significativamente mayores en el grupo con ISNF que en el de control. No hubo diferencias significativas entre los grupos con ISNF y de control en las concentraciones de ácido úrico, PCRas y adiponectina. Los valores del GIMC en el grupo con ISNF fueron significativamente mayores que los del grupo de control (0,74±0,14 frente a 0,53±0,09; p<0,001). El valor medio del GIMC mostró una correlación estadísticamente positiva con la edad (r=0,245; p=0,004); la puntuación del HOMA-IR (r=0,490; p<0,001), y la GA (r=0,521; p<0,001), la insulina en ayunas (r=0,432; p<0,001), el colesterol total (CT) (r=0,267; p=0,002) y el fibrinógeno (r=0,398; p<0,001) en el grupo con ISNF.

Conclusión:

Los resultados indicaban que los pacientes con ISNF tenían un riesgo elevado de resistencia a la insulina, con síndrome metabólico y aumento de los valores del GIMC. Deben diseñarse estudios de seguimiento a largo plazo para evaluar los cambios posquirúrgicos de los parámetros metabólicos y los factores de riesgo cardiovascular en pacientes con ISFN
Assuntos
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Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Resistência à Insulina / Doenças Cardiovasculares / Fatores de Risco / Neoplasias das Glândulas Suprarrenais / Síndrome Metabólica / Achados Incidentais / Espessura Intima-Media Carotídea Limite: Adulto / Feminino / Humanos / Masculino Idioma: Inglês Revista: Endocrinol. diabetes nutr. (Ed. impr.) Ano de publicação: 2019 Tipo de documento: Artigo Instituição/País de afiliação: Ankara University Faculty of Medicine/Turkey
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Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Resistência à Insulina / Doenças Cardiovasculares / Fatores de Risco / Neoplasias das Glândulas Suprarrenais / Síndrome Metabólica / Achados Incidentais / Espessura Intima-Media Carotídea Limite: Adulto / Feminino / Humanos / Masculino Idioma: Inglês Revista: Endocrinol. diabetes nutr. (Ed. impr.) Ano de publicação: 2019 Tipo de documento: Artigo Instituição/País de afiliação: Ankara University Faculty of Medicine/Turkey
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