Anthropometric, haemodynamic, humoral and hormonal evaluation in patients with incidental adrenocortical adenomas before and after surgery.
OBJECTIVE
To compare clinical and humoral parameters before and after surgery in patients with incidental adrenocortical adenomas.


METHODS
Six patients with subclinical Cushing's syndrome and nine with non-functioning adenomas were investigated before and 12 Months after removal of the mass.


METHODS
Anthropometric (body weight, body mass index and waist to hip ratio), haemodynamic (blood pressure and heart rate), metabolic (lipids and oral glucose tolerance test (OGTT)), hormonal (cortisol, plasma renin activity, aldosterone, androgens and catecholamines) and bone metabolism (hydroxyproline, parathyroid hormone, osteocalcin and ostase) parameters were evaluated.


RESULTS
In the whole group, a significant decrease in body weight (69.7+/-3.5 vs 70.8+/-3.5 kg, P<0.03), in systolic (135.3+/-5.1 vs 145.6+/-4.9 mmHg, P<0.009) and diastolic (83.7+/-1.9 vs 91.0+/-3.5 mmHg, P<0.03) blood pressure and in glucose levels in response to OGTT (106.4+/-9.6 vs 127.5+/-6.5 mg/dl, P<0.05) was observed after surgery. All other parameters examined did not change significantly. This trend was also found in both groups separately. Analytical data showed a high frequency of overweight/obesity (66.6%), hypertension (66.6%) and impaired glucose profile (26.6%) in our patients, with a greater prevalence of these cardiovascular risk factors in the subclinical Cushing's syndrome group. After surgery, values normalized or improved in eight out of ten hypertensive patients and in three out of four patients with impaired glucose profile.


CONCLUSIONS
Solid adrenocortical incidentalomas are associated with some cardiovascular risk factors which may be corrected after removal of the mass. Therefore, surgery may be an appropriate choice in patients with subclinical Cushing's syndrome but also in those with solid non-functioning adenomas and coexistent cardiovascular risk factors.
Bernini
Giampaolo
G
Department of Internal Medicine, University of Pisa, Pisa, Italy. g.bernini@med.unipi.it
Moretti
Angelica
A
Iacconi
Pietro
P
Miccoli
Paolo
P
Nami
Renato
R
Lucani
Barbara
B
Salvetti
Antonio
A
D000236:Adenoma / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001835:Body Weight; D003480:Cushing Syndrome / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005951:Glucose Tolerance Test; D006439:Hemodynamics; D006728:Hormones / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011184:Postoperative Period; D016896:Treatment Outcome
D001786:Blood Glucose; D006728:Hormones