Adrenal incidentalomas and cardiometabolic morbidity: an emerging association with serious clinical implications

• Published in: Journal of internal medicine Vol. 268; no. 6; pp. 555 - 566
• Main Authors: Peppa, M., Koliaki, C., Raptis, S. A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-12-2010; Blackwell
• Subjects: Adrenal Gland Neoplasms - complications; Adrenal Gland Neoplasms - secretion; Adrenal Gland Neoplasms - surgery; adrenal incidentalomas; Adrenalectomy; Biological and medical sciences; Cushing Syndrome - complications; Epidemiology; General aspects; Humans; Hydrocortisone - secretion; Incidental Findings; insulin resistance; Medical sciences; Metabolic diseases; metabolic syndrome; Metabolic Syndrome - complications; Miscellaneous; nonfunctioning adrenal incidentalomas; Other metabolic disorders; Public health. Hygiene; Public health. Hygiene-occupational medicine; subclinical Cushing’s syndrome; Endocrinopathy; Pancreatic hormone; Adrenal cortex diseases; subclinical Cushing's syndrome; Adrenal gland neoplasm; Cushing syndrome; adrenal incidentalomas; nonfunctioning adrenal incidentalomas; Metabolic diseases; Cardiovascular disease; Hyperadrenocorticism; Asymptomatic; Metabolic syndrome; Epidemiology; Insulin; Morbidity; Medicine; Target tissue resistance; Symptomatology; Association; Treatment; Adrenal gland diseases; Insulin resistance
• ISSN: 0954-6820; 1365-2796
• DOI: 10.1111/j.1365-2796.2010.02291.x

.  Peppa M, Koliaki C, Raptis SA (Athens University Medical School, Attikon University Hospital, Haidari, Athens; Hellenic National Diabetes Center for the Prevention, Research and Treatment of Diabetes Mellitus and its Complications (H.N.D.C), Athens, Greece). Adrenal incidentalomas and cardiometabolic morbidity: an emerging association with serious clinical implications (Review). J Intern Med 2010; 268: 555–566.
Adrenal incidentalomas (AIs) represent adrenal masses that are incidentally discovered whilst investigating symptoms and signs unrelated to adrenal pathology. The onset and natural course of AIs are unknown, and the possible underlying cardiometabolic abnormalities have not been examined in depth. A growing body of clinical and experimental evidence supports the notion that both functioning and, paradoxically, nonfunctioning AIs are associated with a partially expressed or even full‐blown metabolic syndrome (MS) phenotype, through yet unclear mechanisms. Subtle, subclinical or even profound adrenal hormone excess and an increased proinflammatory state might explain to some extent the development of MS disturbances. The emerging association between AIs and MS appears to be important in determining the optimal clinical management of these patients and raises speculation about the exact mechanisms of this interesting cause–effect relationship.