Adipocytokines in Non-functional Adrenal Incidentalomas and Relation with Insulin Resistance Parameters

Abstract

Objective: Adrenal incidentalomas are diagnosed incidentally during radiological screenings and require endocrinological investigations for hormonal activity and malignancy. In certain studies, it has been reported that non-functional incidentalomas can be associated with high adipocytokines levels affecting the insulin resistance just like the adipose tissue with metabolic syndrome. Here, we studied serum adipocytokine levels including leptin, resistin, visfatin, omentin 1 and adiponectin in subjects with non-functional adrenal incidentaloma. Methods: Seventy-seven (77) patients (Female 57; Male 20) with non-functional adrenal incidentaloma (NFAI) were enrolled in the study. All patients’ past medical history, physical examination including Body Mass Index (BMI) and waist circumference were performed. The patients’ demographic, radiologic, hormonal and biochemical parameters were recorded. To compare the parameters, a control group (CG) (n=30) was formed from healthy volunteers. Both groups were matched for age, gender, waist circumference and BMI. Serum adipocytokines including leptin, resistin, visfatin, omentin 1 and adiponectin were measured quantitatively by ELISA. Fasting plasma glucose, insulin, sodium, potassium, cortisol, adrenocorticotropic hormone (ACTH), lipid profiles, and dehidroepiandrostenedion sulphate (DHEAS) were measured. Results: Mean age of the patients was 52.2±10.4 years. BMI and waist circumference of NFAI patients were 26.2±3.28 kg/m2 and 90.2 ±7.5cm, respectively. The mean age of the control group was 48.0±8.16. BMI and waist circumference values for the control group were 25.3±3.5 kg/m2 and 88.3±9.6 cm, respectively. When both groups were compared for age, gender, BMI and waist circumference were non-significant (p>0.05). Serum fasting insulin, total cholesterol, LDL, triglyceride levels of the NFAI group were significantly higher than CG (p<0.05). The insulin resistance index (HOMAIR) values of the NFAI subjects were found to be higher than CG (2.5±1.37, 1.1±0.3 p=0.00). Resistin level of NFAI group was also found to be higher than CG [286.6 ng/L vs. 197 ng/L; (P=0,00)], respectively. Leptin levels of NFAI were significantly higher than CG [441.1 ng/mL vs. 186.5 ng/mL; (P=0.00)] respectively. Adiponectin levels were significantly reduced in the NFAI group than in the CG [10.7 mg/L vs. 30.8 mg/L; (P=0.00)]. Comparision of visfatin and omentin levels was nonsignificant. Conclusion: In this study on subjects with non-functional adrenal incidentaloma, we found not only significantly decreased serum adiponectin levels but also increased leptin, resistin levels as well as dyslipidemia, hypertension and high insulin resistance index. All of which could affect insulin resistance and cardiovascular risk factors. The underlying mechanisms of these findings are unknown, hence further studies are needed.

Monocyte Count to HDL-Cholesterol Ratio May Be a Novel Cardiometabolic Marker in Patients With Functional Adrenal Tumors

“…Non-functional adrenal adenoma showed worse endothelial alterations rather than established atherosclerosis (34,35). Akkus reported that nonfunctional adrenal adenoma was associated with increased adipocytokines levels, which affect the insulin resistance and cardiovascular risk factors (36). Our patients with non-functional adrenal adenoma may possibly present in the early stage of inflammation and atherosclerosis, which might be explained why MHR does not associate with non-functional adrenal adenoma.…”

Serum Visfatin/NAMPT as a Potential Risk Predictor for Malignancy of Adrenal Tumors

“…On the other hand, Akkus et al [ 10 ] assessed serum adipocytokine levels, including visfatin, leptin, resistin, omentin 1, and adiponectin in patients with non-functional adrenal incidentalomas (NFAI). These patients demonstrated significantly elevated leptin and resistin levels, as well as significantly decreased adiponectin levels.…”

“…Overweight or obesity are common conditions accompanying hormonally active as non-functionating adrenal tumors. Adipose tissue works as an endocrine gland secreting adipocytokines such as resistin, leptin, adiponectin, and visfatin, affecting insulin resistance and metabolic syndrome [ 10 , 11 ]. There are not many studies specifying the role and contribution of adipocytokines in the biology of ACC [ 10 , 12 , 13 ].…”

“…Adipose tissue works as an endocrine gland secreting adipocytokines such as resistin, leptin, adiponectin, and visfatin, affecting insulin resistance and metabolic syndrome [ 10 , 11 ]. There are not many studies specifying the role and contribution of adipocytokines in the biology of ACC [ 10 , 12 , 13 ]. Visfatin, also known as nicotinamide phosphoribosyltransferase (NAMPT) or pre-B-cell-enhancing factor, is a novel adipocytokine expressed mostly in visceral adipose tissue, though detectable in most cell types such as macrophages, leucocytes, primary glial cells, or fibroblasts.…”

Which BMI for Diabetes Patients is Better? From the View of the Adipose Tissue Macrophage-Derived Exosome

“…41 Previous studies illustrated that adipocytokine played significant roles in regulation of glucose, lipid and metabolism energy metabolism, which mediated insulin resistance in cardiovascular disease of type 2 diabetes. 42,43 The other major adipokine except adipocytokine is leptin. Leptin levels increase in obesity.…”