Division of Endocrinology and Metabolism, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Curr Opin Endocrinol Diabetes Obes. 2021 Jun 1;28(3):277-282. doi: 10.1097/MED.0000000000000628.
The incidence of adrenal tumors has increased over the past 20 years, most of which are incidentally discovered nonfunctioning adenomas (NFA) and tumors with mild autonomous cortisol secretion (MACS). This review aimed to summarize recent progress in understanding cardiometabolic risk in patients with NFA and MACS and to provide updates on the effect of treatment on improving outcomes in this population.
NFA and MACS are associated with adverse cardiovascular risk factors and metabolic derangements, which are likely mediated by excessive glucocorticoid secretion. Recent studies showed significantly higher prevalence of hypertension, impaired glucose metabolism, obesity, and dyslipidemia in patients with NFA and MACS. Adrenalectomy may improve comorbidities in selected patients.
Asymptomatic adrenal adenomas are common and are associated with adverse cardiometabolic changes. In selected patients, adrenalectomy may reduce cardiometabolic risk and improve clinical outcomes.
过去 20 年来，肾上腺肿瘤的发病率有所增加，其中大多数为偶然发现的无功能腺瘤（NFA）和具有轻度自主皮质醇分泌的肿瘤（MACS）。本综述旨在总结目前对 NFA 和 MACS 患者的心脏代谢风险的认识进展，并提供关于治疗对改善该人群预后效果的最新信息。
NFA 和 MACS 与不良心血管危险因素和代谢紊乱有关，这可能是由过量糖皮质激素分泌介导的。最近的研究表明，NFA 和 MACS 患者中高血压、葡萄糖代谢受损、肥胖和血脂异常的发生率明显更高。肾上腺切除术可能改善某些患者的合并症。
无症状的肾上腺腺瘤很常见，与不良的心脏代谢变化有关。在某些患者中，肾上腺切除术可能降低心脏代谢风险并改善临床结局。
