Department of Internal Medicine and Endocrine Unit, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Endocrine Division, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Rio de Janeiro, Brazil.
Clin Endocrinol (Oxf). 2018 Nov;89(5):586-595. doi: 10.1111/cen.13822. Epub 2018 Aug 21.
Although metabolic syndrome has been studied in patients with autonomous cortisol secretion, there are limited data for those with nonfunctioning adrenal incidentaloma (NFAI).
To assess metabolic syndrome frequency in NFAI patients and controls without adrenal adenoma according to World Health Organization (WHO), National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) and International Diabetes Federation (IDF) criteria.
Retrospective and transversal study.
Seventy-four NFAI and 90 controls were evaluated. NFAI diagnosis was established according to current guidelines. The control group was selected based on normal adrenal imaging examinations.
Subjects were categorized by metabolic syndrome presence according to WHO, NCEP-ATP III, AACE/ACE and IDF.
Age, gender, ethnicity, body mass index, smoking, menopause, statin and fibrate use were comparable between patients and controls. The frequency of prediabetes, dyslipidaemia and hypertension as well as waist circumference were significantly higher in the NFAI patients compared to the controls. The metabolic syndrome frequency in the NFAI group was significantly higher compared to the normal adrenal group: WHO: 69.2% × 31.0% (P < 0.001); NCEP-ATP III: 81.7% × 44.9% (P < 0.001); AACE/ACE: 77.1% × 31.9% (P < 0.001); IDF: 78.6% × 45.5% (P < 0.001). Logistic regression analysis showed that NFAI was a predictor of metabolic syndrome according to WHO (P = 0.001), NCEP-ATP III (P = 0.005) and AACE/ACE (P = 0.007).
Metabolic syndrome is frequently found in patients with NFAI, and this frequency is higher in NFAI patients than in those with normal adrenal imaging.
尽管自主皮质醇分泌患者的代谢综合征已有研究，但无功能性肾上腺意外瘤（NFAI）患者的数据有限。
根据世界卫生组织（WHO）、美国国家胆固醇教育计划-成人治疗专家组第三版（NCEP-ATP III）、美国临床内分泌医师协会/美国内分泌学会（AACE/ACE）和国际糖尿病联合会（IDF）标准，评估 NFAI 患者和无肾上腺腺瘤对照者中代谢综合征的发生率。
回顾性和横断面研究。
共评估了 74 例 NFAI 患者和 90 例对照者。根据现行指南确定 NFAI 诊断。对照组是根据正常肾上腺影像学检查选择的。
根据 WHO、NCEP-ATP III、AACE/ACE 和 IDF 标准，将受试者分为代谢综合征阳性和阴性。
患者和对照组的年龄、性别、种族、体重指数、吸烟、绝经、他汀类药物和贝特类药物使用情况相似。与对照组相比，NFAI 患者的糖尿病前期、血脂异常和高血压以及腰围发生率更高。与正常肾上腺组相比，NFAI 组的代谢综合征发生率显著更高：WHO：69.2%×31.0%（P＜0.001）；NCEP-ATP III：81.7%×44.9%（P＜0.001）；AACE/ACE：77.1%×31.9%（P＜0.001）；IDF：78.6%×45.5%（P＜0.001）。Logistic 回归分析显示，NFAI 是 WHO（P=0.001）、NCEP-ATP III（P=0.005）和 AACE/ACE（P=0.007）标准下代谢综合征的预测因素。
代谢综合征在 NFAI 患者中较为常见，且在 NFAI 患者中的发生率高于无肾上腺影像学异常的患者。
