Department of Cardiology, Mustafa Kemal University, Hatay, Turkey.
Department of Endocrinology and Metabolism, Antakya State Hospital, Hatay, Turkey.
Endocr Metab Immune Disord Drug Targets. 2021;21(7):1319-1325. doi: 10.2174/1871530320666200910110337.
We evaluated cardiovascular (CV) risk stratification for nonfunctioning adrenal incidentalomas (NFAIs) via the coronary-artery-calcium (CAC) score.
The participants were patients with NFAI (n = 55). They were compared to patients with chest pain, a low-intermediate Framingham-risk score, and a non-diagnostic treadmill- exercise test, which served as the control group (n = 49). Subsequently, the NFAI group was subdivided according to a CAC score of <100 Agatston units - mild coronary-artery calcification (n = 40) - and ≥100 Agatston units - moderate-to-severe calcification (n = 15).
Similar rates of traditional risk factors were observed between the NFAI and control groups, and lower low-density lipoprotein cholesterol rates were observed in the NFAI group. The CAC score was significantly higher for the NFAI group than the control group. Glucose, potassium, adrenocorticotropic-hormone, and basal-cortisol levels were higher in those with a CAC score of ≥100. High-density-lipoprotein cholesterol estimated glomerular filtration rate and ejection fraction (EF) were higher in those with a CAC score of <100. Adenoma size and location were similar between the groups. Age, EF, and glucose were the most significant variables related to CAC score in patients with NFAI, at ≥100 Agatston units.
Patients with a low-intermediate CV risk profile and NFAI have a higher risk of atherosclerosis when compared to patients with a low-intermediate CV risk profile, but no NFAI.
In patients with NFAI, CAC score evaluation may be used to predict increased atherosclerosis, especially in patients of an older age with higher glucose and decreased EF.
我们通过冠状动脉钙评分（CAC 评分）评估无功能性肾上腺意外瘤（NFAI）患者的心血管（CV）风险分层。
参与者为 NFAI 患者（n=55）。将其与胸痛、中低Framingham 风险评分和非诊断性跑步机运动试验的患者进行比较，作为对照组（n=49）。随后，根据 CAC 评分将 NFAI 组分为<100 个 Agatston 单位（轻度冠状动脉钙化，n=40）和≥100 个 Agatston 单位（中重度钙化，n=15）。
NFAI 组和对照组的传统危险因素率相似，NFAI 组的低密度脂蛋白胆固醇水平较低。NFAI 组的 CAC 评分明显高于对照组。CAC 评分≥100 的患者血糖、钾、促肾上腺皮质激素和基础皮质醇水平较高。CAC 评分<100 的患者高密度脂蛋白胆固醇、估算肾小球滤过率和射血分数（EF）较高。两组间的腺瘤大小和位置相似。在 CAC 评分≥100 的 NFAI 患者中，年龄、EF 和血糖是与 CAC 评分最相关的变量。
与中低 CV 风险且无 NFAI 的患者相比，中低 CV 风险且有 NFAI 的患者发生动脉粥样硬化的风险更高。
在 NFAI 患者中，CAC 评分评估可用于预测动脉粥样硬化的增加，尤其是在年龄较大、血糖较高且 EF 降低的患者中。
