School of Medicine, European University Cyprus, Nicosia, Cyprus.
School of Medicine, European University Cyprus, Nicosia, Cyprus; Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Maturitas. 2019 Mar;121:1-6. doi: 10.1016/j.maturitas.2018.12.002. Epub 2018 Dec 5.
An adrenal incidentaloma (AI) is an adrenal mass incidentally found via a radiological modality, independent of an endocrinological investigation. In this review, we aimed to investigate the possible reasons behind the increased frequency in AI detection, especially in ageing populations. The pathophysiological effects of insulin resistance (IR), hyperinsulinemia and various anabolic pathways are analyzed. In addition, we review data from studies indicating an increased incidence of adrenal adenomas and carcinomas in patients with type 2 diabetes mellitus (T2DM). The establishment of obesity as a global epidemic, with a higher prevalence in the female than in the male population, coincide with data regarding AIs and the conditions may share a pathophysiological basis. Furthermore, we discuss the bidirectional association of AIs with obesity, insulin resistance and T2DM, especially in patients with autonomous cortisol secretion. Lastly, as per the definition of an AI, we touch upon the evolution of radiological imaging as another possible cause of the rise in prevalence of AIs, especially concerning the greater use and precision of computed tomography (CT).
肾上腺意外瘤（AI）是指通过影像学手段偶然发现的肾上腺肿块，与内分泌学检查无关。在这篇综述中，我们旨在探讨 AI 检测频率增加的可能原因，特别是在老龄化人群中。分析了胰岛素抵抗（IR）、高胰岛素血症和各种合成代谢途径的病理生理效应。此外，我们还回顾了表明 2 型糖尿病（T2DM）患者肾上腺腺瘤和癌发病率增加的数据。肥胖作为一种全球性流行疾病，女性的发病率高于男性，与 AI 数据相吻合，两者的发病机制可能存在共同的病理基础。此外，我们还讨论了 AI 与肥胖、胰岛素抵抗和 T2DM 之间的双向关联，特别是在自主皮质醇分泌的患者中。最后，根据 AI 的定义，我们还探讨了影像学成像的发展，这也是 AI 患病率上升的另一个可能原因，特别是与 CT 的广泛应用和精度提高有关。
