Session: MON 1-36-Adrenal Incidentaloma & Carcinoma
Poster Board MON-6
Methods. In this retrospective study all patients referred to 7 Italian Endocrine Centers for AI, without signs of hypercortisolism at baseline and with a ≥5 years follow-up (81.9±31.5 months, range 60-286), were enrolled. From 196 patients (138 F) aged 59.2±10.2 yrs (range 25-79) the changes in weight, glucose and lipid metabolism, blood pressure control and the occurrence of CVE were obtained. Patients were classified as affected with subclinical hypercortisolism (SH) in the presence of cortisol after 1–mg dexamethasone suppression (1-mgDST) test >5 mcg/dl or ≥2 parameters out of low ACTH, increased urinary free cortisol and 1-mgDST >3 mcg/dl.
Results. At baseline SH was found in the 10.7% of patients. The prevalence of obesity, diabetes mellitus, dyslipidemia and arterial hypertension (29%, 20%, 43% and 56%, respectively) was not different between patients with (SH+) and without SH (SH-). At baseline SH+ patients showed a higher CVE prevalence than SH- ones (24% vs 7%), regardless of age (OR 3.8, 95%CI 1.1-12.4, P<0.05). At the end of follow-up a new diagnosis of SH was made in the 7.1% of patients. The adenoma size (baseline 2.3±0.8 cm) increased >2.5 cm in the 2.0% of cases. The glucose and lipid metabolism, blood pressure and weight control worsened in the 24.5%, 16%, 33% and 15% of patients, respectively. The SH persistence/appearance was significantly associated with the worsening of ≥2 out of the metabolic parameters (P=0.005) and with the occurrence of new CVE (P=0.035).
Conclusion. In AI patients a long-term follow-up is recommended for the diameter increase and SH development risk. SH patients are at risk of worsening of the metabolic control and, importantly, of CVE.
Disclosure: MT: Ad Hoc Consultant, HRA Pharma. Nothing to Disclose: AS, GR, VM, RG, SD, CP, AS, SP, AD, MA, BA, EGGMG, PB, IC
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