Prevalence of adrenal masses in Japanese patients with type 2 diabetes mellitus

Abstract

IntroductionTo date, there have been no reports on the prevalence of adrenal masses in type 2 diabetic patients. The present study aimed to evaluate the prevalence of adrenal incidentaloma in type 2 diabetic patients in Japan.SubjectsWe retrospectively evaluated the presence of adrenal masses using abdominal CT scans in 304 type 2 diabetic patients. In those with adrenal masses, we examined the hormone production capacity of the adrenal mass.ResultsFourteen patients (4.6%) had an adrenal mass. Hormonal analysis identified one case as having subclinical Cushing's syndrome, two with primary aldosteronism. Eleven cases had non-functioning masses.DiscussionThe reported prevalence of adrenal incidentaloma in normal subjects is 0.6-4.0% in abdominal CT scan series. Our results show a relatively high prevalence of adrenal tumors in diabetic patients. On the other hand, the frequency of functional adenoma in diabetic patients is 21.4%, which is similar to that of normal subjects.ConclusionAlthough further studies are needed to evaluate the prevalence of adrenal tumors in diabetic patients, our data suggest that evaluation of the presence of adrenal masses may be needed in patients with type 2 diabetes mellitus.

Adrenocortical tumors and insulin resistance: What is the first step?

“…Several studies evaluated the potential effect of chronic hyperinsulinemia on adrenal tumor growth in patients with T2DM. Hiroi et al retrospectively evaluated the prevalence of ACTs using abdominal computed tomography scan in a large cohort of T2DM patients . They found an increased prevalence of ACTs in diabetic patients compared to normal subjects (4.6% vs .…”

DIAGNOSIS OF ENDOCRINE DISEASE: Prevalence of hypercortisolism in type 2 diabetes patients: a systematic review and meta-analysis

“…Subsequent imaging performed in the patients with hypercortisolism revealed either adrenal adenoma(s) or a pituitary adenoma in 52 and 15%, respectively, which points toward a potentially curable condition in these patients. In seven of the studies including 1873 patients (12,14,18,19,20,22,25), post-surgical outcome data were provided. Each of the 17 post-surgically evaluated patients (0.9%) showed significantly improved glycemic control, and weight loss and lowering of blood pressure were occurred in a subset.…”

“…Included studies were published between 1996 and 2012. Of the 14 studies, 11 were cohort studies (12,13,14,15,16,17,18,19,20,21,22) and three were case-control studies (of which only data on the group with T2D patients were considered) (23,24,25). The 14 study groups contained a total of 2827 T2D patients, none of whom was treated with corticosteroids in any form.…”

“…An overview of performed tests and their sequence is provided in Table 2. Seven studies diagnosed CS based on both positive biochemical tests and positive imaging (14,15,18,19,23,24,25), three studies used positive biochemical tests only, (16,20,22) and two studies required peroperative or histological evidence of an underlying tumor (12,21).…”

“…The reported mean age of the patients ranged from 53.5 to 63 years, mean BMI of the patients ranged from 25.0 to 34.5 kg/m 2 , and mean HbA1c ranged from 7.7 to 12.2%. As regards firststep screening, 13 studies used biochemical testing and one study (22) used abdominal CT scan; nine studies were based on inclusion of outpatients, (13,14,15,17,20,21,22,23,24) 4 studies on inpatients (12,16,19,25), and one on both inpatients and outpatients (18).…”