Atherosclerotic risk factors and complications in patients with non-functioning adrenal adenomas treated with or without adrenalectomy: a long-term follow-up study.
OBJECTIVE
Despite the increased prevalences of hypertension, type 2 diabetes mellitus (T2DM), hyperlipidemy, and obesity in patients with non-functioning adrenal adenomas (NFAAs), there is a paucity of data on long-term atherosclerotic morbidity as well as the long-term cardiovascular effects of adrenalectomy in these patients.


METHODS
This retrospective study includes the results of baseline and follow-up investigations of 125 patients (29 males and 96 females; mean age 60.1 years) with NFAAs referred for endocrine evaluation between 1990 and 2001. Of the 125 patients, 47 underwent unilateral adrenalectomy, while 78 patients were followed conservatively. These patients were reinvestigated after a mean follow-up time of 9.1 (5-16) years in 2006, with special emphasis on laboratory and other atherosclerotic risk factors (ARF), vascular events, and interventions.


RESULTS
The prevalences of hypertension, impaired glucose tolerance or T2DM, hyperlipidemy, and obesity were 82, 43, 58, and 50%, and 89, 58, 82, and 50% at baseline and follow-up, respectively. None of the investigated ARF prevalences were different between patients treated and not treated with adrenalectomy, and between patients with and without subclinical Cushing's syndrome. The prevalences of angina pectoris, acute myocardial infarction, coronary, and peripheral arterial interventions or cerebrovascular stroke did not differ significantly between patients treated and not treated with adrenalectomy.


CONCLUSIONS
Our study confirms previous investigations reporting markedly increased prevalences of various ARF in patients with NFAAs. Adrenalectomy performed in these patients failed to decrease the prevalence of ARF and atherosclerotic morbidity.
Sereg
Márta
M
2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Szappanos
Agnes
A
Toke
Judit
J
Karlinger
Kinga
K
Feldman
Karolina
K
Kaszper
Eva
E
Varga
Ibolya
I
Gláz
Edit
E
Rácz
Károly
K
Tóth
Miklós
M
D000306:Adrenal Cortex Neoplasms / Q000150:complications* / Q000601:surgery / Q000628:therapy*; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000601:surgery / Q000628:therapy*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D003480:Cushing Syndrome / Q000097:blood / Q000209:etiology; D003920:Diabetes Mellitus / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone