Clinical Characteristics and Metabolic Features of Patients with Adrenal Incidentalomas with or without Subclinical Cushing's Syndrome.
10.3803/EnM.2014.29.4.457
- Author:
Bo Yeon KIM
1
;
A Reum CHUN
;
Kyu Jin KIM
;
Chan Hee JUNG
;
Sung Koo KANG
;
Ji Oh MOK
;
Chul Hee KIM
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. byby815@schmc.ac.kr
- Publication Type:Original Article
- Keywords:
Adrenal incidentalomas;
Metabolic features;
Subclinical Cushing's syndrome
- MeSH:
Adenoma;
Body Mass Index;
Cholesterol;
Cushing Syndrome*;
Diabetes Mellitus, Type 2;
Fasting;
Glucose;
Gyeonggi-do;
Humans;
Hydrocortisone;
Hyperaldosteronism;
Hypertension;
Korea;
Medical Records;
Pheochromocytoma;
Prevalence;
Retrospective Studies;
Tertiary Care Centers
- From:Endocrinology and Metabolism
2014;29(4):457-463
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The aim of this study was to examine the clinical characteristics of adrenal incidentalomas discovered by computed tomography (CT) and to investigate metabolic features of subclinical Cushing's syndrome (SCS) in patients with adrenal incidentalomas in a tertiary hospital in Korea. METHODS: This retrospective study examined the clinical aspects of 268 patients with adrenal incidentalomas discovered by CT at Soonchunhyang University Bucheon Hospital. Clinical data and endocrine function of the patients as well as histological findings were obtained from medical records, while anatomic characteristics were analyzed by reviewing imaging studies. Hormonal tests for pheochromocytoma, Cushing's syndrome, and aldosterone-secreting adenoma were performed. RESULTS: Most (n=218, 81.3%) cases were nonfunctioning tumors. Of the 50 patients with functioning tumors (18.7%), 19 (7.1%) were diagnosed with SCS, nine (3.4%) with overt Cushing's syndrome, 12 (4.5%) with primary aldosteronism, and 10 (3.7%) with pheochromocytoma. Malignant tumors (both primary and metastatic) were rare (n=2, 0.7%). Body mass index, fasting glucose, hemoglobin A1c, and total cholesterol were significantly higher in patients with SCS in comparison with those with nonfunctioning tumors. The prevalence of type 2 diabetes mellitus and hypertension were significantly higher in patients with SCS compared with those with nonfunctioning tumors. CONCLUSION: Functioning tumors, especially those with subclinical cortisol excess, are commonly found in patients with adrenal incidentalomas, although malignancy is rare. In addition, patients with SCS in adrenal incidentalomas have adverse metabolic and cardiovascular profiles.
