Adverse cardio-metabolic risk profile and epicardial adiposity in patients with adrenal adenoma: a cross-sectional study.

BACKGROUND: Mild autonomous cortisol secretion (MACS) is associated with an increased cardiovascular mortality, but even patients with non-functioning adrenal adenoma (NFA) might be at risk for cardio-metabolic comorbidities compared to a control group with absence of an adrenal tumor (CON). MATERIAL AND METHODS: Seventyfour individuals were included in cross-sectional analysis [MACS: n=25(84% females), age: 63(55-67)years, BMI:27.00(24.20-30.50)kg/m2; NFA: n=25(84%females), age: 61(54-68)years, BMI:28.50(27.50-32.20)kg/m2 and CON: n=24 (75%females), age: 58 (51-64)years, BMI: 27.39(22.03-30.17) kg/m2]. Visceral and ectopic fat stores, as well as heart function were assessed by magnetic resonance imaging and spectroscopy. Blood pressure was measured by standardized protocols. Blood was drawn in the fasting state and during an oral glucose tolerance test to assess glucose and lipid metabolism. RESULTS: The prevalence of hypertension (MACS:84% vs NFA:76% vs CON: 43.5%), dyslipidemia (MACS:96% vs NFA:80% vs CON:62.5%) and prediabetes (MACS:56% vs. NFA:72% vs CON:29.2%) was significantly different between the groups. Markers of glucose metabolism were worse in MACS and best in CON (HbA1c: 5.70 (5.40-5.90)% vs 5.50 (5.40-5.80)% vs 5.40 (5.27-5.60)%, p=0.043); HOMA_IR:2.91(2.19-4.15) vs 2.55 (1.57- 4.97) vs 1.73 (1.00-2.61), p=0.007). epicardial adipose tissue area was highest in MACS patients, followed by NFA, with lowest values in CON (MACS:1159.68 (930.38-1454.11) mm2 vs NFA: 873.23 (638.03-1195.33) mm2 vs CON:672.37 (549.44-890.30) mm2, p<0.001). No relevant between-group-differences in cardiac morphology, intramyocardial fat or intrahepatic fat were observed. CONCLUSIONS: In this exploratory study, MACS was associated with epicardial adiposity and an adverse cardio-metabolic risk profile.