Carotid Intima-Media Thickness as the Cardiometabolic Risk Indicator in Patients with Nonfunctional Adrenal Mass and Metabolic Syndrome Screening
Mehtap Evran, Gamze Akkuş, İlayda Berk Bozdoğan, Mustafa Gök, Ali Deniz, Murat Sert, Tamer Tetiker
Department of Internal Medicine, Division of Endocrinology, Cukurova University, Medical Faculty, Adana, Turkey
Med Sci Monit 2016; 22:991-997
Our purpose was to show the association of adrenal incidentaloma and metabolic syndrome in consideration of the studies and to detect the increase in the carotid intima-media thickness which is regarded as the precessor of atherosclerosis.
MATERIAL AND METHODS: Eighty-one patients who were diagnosed with adrenal mass were included in the study. Hormonal evaluation, insulin rezistance measurement with the HOMA-IR and 1-mg DST were performed of all patients. The patients were classified as follows: mass size <3 cm (K1) and mass size of at least 3 cm (K2). Echocardiography and carotid intima-media thickness of the patients were measured using B-mode ultrasound. Thirty-three healthy individuals were enrolled as the control group.
RESULTS: Mass size of 64.19% K1, while mass size of the remainder (35.81%) K2 was calculated. Five of the patients with adrenal mass were detected to have subclinical Cushing syndrome. The remaining 76 patients were accepted as nonfunctional. It was seen with regard to metabolic and biochemical parameters that plasma glucose (p=0.01), insulin (p=0.00) and triglyceride (p=0.012) values of all patients were significantly high compared to those of the control group. It was detected that measured heart rate (p=0.00), end-diastolic diameter (p=0.02), end-systolic diameter (p=0.014) and carotid intima-media thickness (p=0.00) values of the patients with adrenal mass were significantly higher than those of the healthy control group.
CONCLUSIONS: We found that the increased insulin resistance, increased risk of cardiovascular disease with the increase in the thickness of carotid intima-media and diastolic disfunction parameters, although the patients with adrenal incidentaloma are nonfunctional.
Keywords: Cardiovascular Diseases - metabolism, Adrenal Gland Neoplasms - physiopathology, carotid intima-media thickness, Case-Control Studies, Cushing Syndrome - physiopathology, Demography, Electrocardiography, Hormones - metabolism, Mass Screening, Metabolic Syndrome X - physiopathology, Risk Factors