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| |  Patients With Adrenal Incidentalomas Have Increased Prevalence of Metabolic Syndrome: Presented at ECE By Karen Dente PRAGUE, Czech Republic -- April 30, 2010 -- Study results presented here at the 12th European Congress of Endocrinology (ECE) show that there is a high prevalence of metabolic syndrome in patients with adrenal incidentalomas and subclinical autonomous cortisol hypersecretion. Andromachi Vryonidou, MD, Department of Endocrinology, Diabetes, and Metabolism, Red Cross Hospital, Athens, Greece, and colleagues evaluated 194 patients with newly diagnosed adrenal incidentalomas by computed tomography. Of those, 121 patients were included that did not show overt disease or a previous history of type 2 diabetes for evaluation of metabolic syndrome. They underwent a hormonal and biochemical evaluation. "We based the diagnosis of subclinical Cushing's syndrome on a post-LDDST [low-dose dexamethasone suppression test] plasma cortisol level >=1.8 mcg/dL combined with an abnormal result of at least 1 other test of the hypothalamic-pituitary-adrenal axis and the absence of clinical signs of cortisol excess," Dr. Vryonidou explained during a poster session on April 25. The detection of metabolic syndrome was based on the adult treatment panel III. "Subclinical autonomous cortisol hypersecretion is the most common hormonal abnormality in patients with adrenal incidentalomas, characterised by subtle abnormalities of the hypothalamic-pituitary-adrenal axis due to adrenal autonomy," said Dr. Vryonidou. The detrimental effects of subclinical hypercortisolism in these patients is currently still under investigation. A total of 87 patients had a normal adrenal function and 33 had subclinical Cushing's syndrome. Patients with subclinical Cushing's syndrome did not distinguish themselves clinically from patients with normal adrenal function or in terms of hypertension, but they did display significantly higher fasting glucose levels and higher triglyceride levels than patients with normal functioning adrenal glands. Metabolic syndrome was more prevalent in patients with subclinical Cushing's syndrome (15/33) than patients with normal adrenal function (18/87; P < .01). "We were able to demonstrate with our study that patients with adrenal incidentalomas and subclinical autonomous cortisol hypersecretion have an increased prevalence of metabolic syndrome and that even slight elevations in cortisol may have clinical implications," said Dr. Vryonidou. The latter needs to be further elucidated in prospective studies. [Presentation title: Increased Prevalence of Metabolic Syndrome in Patients With Subclinical Autonomous Cortisol Hypersecretion by Adrenal Incidentalomas. Poster 42]
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