Nonfunctioning and subclinical cortisol secreting adrenal incidentalomas and their association with metabolic syndrome: A systematic review

Khan, Uzma

doi:10.4103/ijem.ijem_52_19

Cited by 16 publications

(9 citation statements)

References 41 publications

(65 reference statements)

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“…42 , 43 Repeated stress is known to lead to persistent elevation of cortisol, which promotes mobilization of fatty acids from adipose tissue and is linked to dyslipidemia. 44 Meditation could stabilize the hypothalamic–pituitary–adrenal axis and thus reduce cortisol secretion induced by stress. 45 The decreased cortisol may be one mechanism by which mediation improves the lipid profile observed in our study.…”

Section: Discussionmentioning

confidence: 99%

The heart-brain axis: A proteomics study of meditation on the cardiovascular system of Tibetan Monks

Xue

Chiao

et al. 2022

eBioMedicine

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Section: Discussionmentioning

confidence: 99%

The heart-brain axis: A proteomics study of meditation on the cardiovascular system of Tibetan Monks

Xue

Chiao

et al. 2022

eBioMedicine

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“…56 In the same line, Bancos meta-analysis 16 found that patients with NFAIs experienced improvement in hypertension after adrenalectomy. Nevertheless, another meta-analysis with the same aim 17 described that there were no significant improvements in cardiometabolic risk factors after adrenalectomy in NFAIs.…”

Section: Nfai and Hypertension And Cardiovascular Eventsmentioning

confidence: 99%

“…8 Otherwise, even in 'nonfunctioning adrenal incidentalomas' (NFAIs), a higher cardiometabolic and mortality risk has been observed than in the general population. [10][11][12][13][14][15] The evidence that supports the existence of an association between NFAIs and an increased cardio-metabolic risk has become stronger in recent years, with meta-analysis, 14,16,17 prospective studies 18,19 and large age-matched cohort studies 13 that found a higher cardiometabolic risk in patients with NFAIs than in healthy controls. This increased risk could be justified by the presence of incipient alterations in cortisol metabolism not detected with classic tests, which over time can progress until they become detectable.…”

mentioning

confidence: 99%

Cardiometabolic profile and urinary metabolomic alterations in non‐functioning adrenal incidentalomas: A review

Araujo‐Castro

2022

Clinical Endocrinology

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Background: The incidence of adrenal incidentalomas (AIs) has increased over the last 20 years, most of which are apparently non-functioning adrenal adenomas. However, increased evidence supports the existence of an association between non-functioning adrenal incidentalomas (NFAI) and an unfavourable cardio-metabolic profile.Methods: This study offers a comprehensive review of the available evidence supporting a higher cardiometabolic risk in NFAIs compared to controls without adrenal tumours. Moreover, it summarises the studies focused on the differential urinary metabolomic profile of NFAI and controls without adrenal lesions.Results: This adverse metabolic profile of patients with NFAI includes a higher prevalence of insulin resistance, obesity, hypertension, hyperglycaemia, dyslipidaemia, and cardiovascular alterations and mortality compared to healthy controls without adrenal tumours. Although the pathophysiology that explains the association between NFAI and the parameters of metabolic syndrome and cardiovascular risk is a relatively unexplored field of study, some evidence supports that there are a series of incipient alterations in cortisol metabolism not detected with the classical tests that led to this detrimental profile. These alterations may be potentially detected by a comprehensive metabolomics approach. Several studies detected a shift towards an increase of urinary cortisol metabolites excretion in NFAIs compared to controls without adrenal tumours. Conclusion:In view of the higher cardiometabolic risk in NFAI than in controls without adrenal tumours, and the detected alterations in metabolomics profile of NFAI, I propose that the term of NFAI should be changed for another term that best fits to its linked cardiometabolic profile.

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“…Another recent study showed higher blood pressure in patients with MACS compared with NFA (systolic blood pressure 145 vs 139 mmHg and diastolic blood pressure 85.7 vs 82.9 mmHg, respectively) [21 & ]. In two recent systematic reviews, baseline hypertension HTN was more prevalent in patients with MACS compared with NFA [12,22] ]. Similar findings were reported in previous studies.…”

Section: Hypertensionmentioning

confidence: 99%

Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas

Hamidi¹

2021

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review The incidence of adrenal tumors has increased over the past 20 years, most of which are incidentally discovered nonfunctioning adenomas (NFA) and tumors with mild autonomous cortisol secretion (MACS). This review aimed to summarize recent progress in understanding cardiometabolic risk in patients with NFA and MACS and to provide updates on the effect of treatment on improving outcomes in this population. Recent findings NFA and MACS are associated with adverse cardiovascular risk factors and metabolic derangements, which are likely mediated by excessive glucocorticoid secretion. Recent studies showed significantly higher prevalence of hypertension, impaired glucose metabolism, obesity, and dyslipidemia in patients with NFA and MACS. Adrenalectomy may improve comorbidities in selected patients. Summary Asymptomatic adrenal adenomas are common and are associated with adverse cardiometabolic changes. In selected patients, adrenalectomy may reduce cardiometabolic risk and improve clinical outcomes.

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Nonfunctioning and subclinical cortisol secreting adrenal incidentalomas and their association with metabolic syndrome: A systematic review

Cited by 16 publications

References 41 publications

The heart-brain axis: A proteomics study of meditation on the cardiovascular system of Tibetan Monks

The heart-brain axis: A proteomics study of meditation on the cardiovascular system of Tibetan Monks

Cardiometabolic profile and urinary metabolomic alterations in non‐functioning adrenal incidentalomas: A review

Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas

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