FRI182 Cardiometabolic Risk and Outcomes In Patient With Adrenal Adenomas

Document Type

Conference Proceeding

Publication Date

10-5-2023

Publication Title

J Endocr Soc

Abstract

Background: Approximately 5% of adults undergoing cross-sectional imaging are reported to have an adrenal adenoma. Although most adenomas are considered non-functioning (NFAT), up to 48% can present with mild autonomous cortisol secretion (MACS). Published studies have reported an increased prevalence of cardiometabolic risk factors, cardiac and cerebrovascular events in MACS patients. Objective: To determine the prevalence of cardiometabolic disease and outcomes in a population-based cohort of patients with adrenal adenomas. Design: Retrospective cross-sectional study of patients with adrenal adenomas over a 10-year period (Jan 2012 - Dec 2021). Setting: Academic primary and tertiary care setting. Main outcomes measured: Prevalence of cardiometabolic disease, cardiovascular events requiring procedure (percutaneous coronary intervention, PCI or coronary artery bypass graft, CABG) and cerebrovascular events. MACS was diagnosed based on cortisol level ≥ 1.8cmg/dL after overnight 1mg dexamethasone suppression testing (DST) and NFAT if cortisol < 1.8mcg/dL. Patients who did not undergo 1mg DST were categorized as unknown cortisol status (UCS). Results: Preliminary results include 198 patients with adrenal adenomas [(135 women (67%) with a median age of 67y, 106 Black (54%), 83 White (42%) and 9 other races (4%)]. 74 (37%) were diagnosed with NFAT, 42 (21%) with MACS, and 82 (41%) with UCS. Hypertension (n=163,83%; MACS vs NFAT vs UCS: 23% vs 34% vs 43%) is the most prevalent cardiometabolic risk factor, followed by hyperlipidemia (n=146, 75%; MACS vs NFAT vs UCS: 21% vs 38% vs 41%), prediabetes (n=94, 50%; MACS vs NFAT vs UCS: 18% vs 43% vs 39%) and type 2 diabetes mellitus (n=82,43%; MACS vs NFAT vs UCS: 22% vs 35% vs 43%), respectively. 14% of patients with adrenal adenomas underwent procedures (PCI or CABG) for cardiovascular events (MACS vs NFAT vs UCS: 33% vs 26% vs 41%) and 11% were diagnosed with cerebrovascular events (MACS vs NFAT vs UCS: 29% vs 19% vs 52%). Conclusions: Patients with adrenal adenomas and mild autonomous cortisol secretion (MACS) are at increased risk of cardiovascular events requiring intervention and cerebrovascular events, compared to nonfunctioning adrenal tumors. 41% (n=82, 61% Blacks, 30% White, 2% Others) of patient population was classified as unknown cortisol status indicating further need to educate health care professionals on evaluation of adrenal adenomas to improve health care outcomes and disparities in management.

Volume

7

First Page

A97

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