Markers of Subclinical Cardiovascular Disease in Nonfunctional Adrenal Incidentaloma Patients without Traditional Cardiovascular Risk Factors

Abstract

Data regarding cardiovascular risk in patients with non-functional adrenal incidentaloma (NFAI) are limited. The objectives of this study are to investigate markers of subclinical cardiovascular disease like carotid intima media thickness (CIMT), pulse wave velocity (PWV), augmentation index (AIx), soluble CD40 ligand (sCD40L) and leptin levels in NFAI patients without traditional cardiovascular risk factors and healthy control group. This study involved 35 patients with NFAI (11 males, 24 females; mean age, 52.4±7.7 years) and 35 healthy subjects as control group (11 males, 24 females; mean age, 51.8±7.2 years). CIMT was evaluated by ultrasonographical methods. PWV and AIx were measured with TensioClinic arteriograph system. Serum leptin and sCD40L levels were measured by ELISA. In NFAI patients group; CIMT (p<0.001), PWV (p<0.001), AIx brachial (p<0.001) and AIx aorta (p=0.008) were found higher than the control group. Cortisol levels after 1mg dexamethasone suppression test (DST) were higher (p=0.006) and DHEASO levels were lower (p=0.008) in NFAI patients than control group. We found that CIMT had positive correlation with age (r=0.484, p<0.005), triglycerides (r=0.378, p<0.005) and cortisol level after 1 mg DST (r=0.346, p<0.005); PWV had positive correlation with total cholesterol (r=0.338, p<0.005) triglycerides (r=0.335, p<0.05) and insulin levels (r=0.426, p<0.005); AIx brachial had a positive correlation with triglycerides (r=0414, p<0.05) and negative correlation with DHEASO (r=-0.380, p<0.005); leptin levels had a positive correlation with body mass index (r=0.541, p<0.001) and HOMA-IR index. We showed that subjects with NFAI without traditional cardiovascular risk factors featured several disturbances (CIMT, PWV and AIx) compared to the control group that could be attributable to increased cardiovascular risk.

Comparison of echocardiographic findings in patients with nonfunctioning adrenal incidentalomas

“…According to previous reports, atherosclerosis prevalence is increased in patients with AIs [20]. Markers of subclinical atherosclerosis (such as carotis intima-media thickness or pulse wave velocity) were found in nonfunctioning AIs without traditional cardiovascular risks [21]. In our study, aortic stiffness was increased in patients with AIs, which is shown by decreased strain and distensibility and increased aortic SI.…”

Markers of Subclinical Cardiovascular Disease in Patients with Adrenal Incidentaloma

“…et al demonstrated higher PWV and peripheral and central AIx in patients with NFAI compared to the control group. PWV showed a positive correlation with total cholesterol, triglyceride, and insulin levels [59]. Similar conclusions were drawn by Akkan T. et al who observed higher PWV and AIx adjusted for heart rate in NFAI patients.…”

“…In Table 2 we summarize all publications included in our review. In the investigated groups of AI patients an increased CIMT was observed, illustrating morphological changes in carotid arteries expressed by intimal hyperplasia and endothelial atherosclerosis, as well as increased PWV or AIx that are the indicators of arterial stiffness [54,55,[58][59][60]63,64]. Endothelial dysfunction in the form of FMD was also observed [55].…”

Osteocalcin Improves Metabolic Profiles, Body Composition and Arterial Stiffening in an Induced Diabetic Rat Model

“…The majority of patients with T2DM concurrently suffer from cardiovascular disease, primarily atherosclerosis, which is exasperated by high blood glucose levels and dyslipidemia. Cardiovascular disease and T2DM are both top causes of death worldwide [2,3], and further work is necessary to develop new therapies extending patient lifespan.…”