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Cardiometabolic Outcomes and Mortality in Patients with Adrenal Adenomas in a Population-based Setting
Catherine D Zhang1, Dingfeng Li1, Ravinder Jeet Kaur1
1Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA.
Insights
Adrenal adenomas increase the risk of cardiometabolic diseases like hypertension and heart failure. This population study shows a higher prevalence and incidence of these conditions in patients with adrenal adenomas.
Area of Science:
- Endocrinology
- Cardiology
- Epidemiology
Background:
- Adrenal adenomas are linked to cardiovascular issues in specialized samples.
- Large-scale, population-based data on adrenal adenomas and cardiometabolic disease are limited.
Purpose of the Study:
- To assess the prevalence and incidence of cardiometabolic diseases in a population-based cohort of patients with adrenal adenomas.
- To evaluate mortality rates in patients with adrenal adenomas compared to a control group.
Main Methods:
- A population-based cohort study was conducted in Olmsted County, Minnesota.
- Patients diagnosed with adrenal adenomas (without hormone excess) were compared to age- and sex-matched referent subjects.
- Data on cardiometabolic outcomes and mortality were collected and analyzed.
Main Results:
- Patients with adrenal adenomas had higher baseline rates of hypertension, dysglycemia, peripheral vascular disease, heart failure, and myocardial infarction.
- Over a median follow-up of 6.8 years, adrenal adenoma patients showed increased incidence of chronic kidney disease, cardiac arrhythmia, peripheral vascular disease, cardiovascular events, and venous thromboembolic events.
- No significant difference in adjusted mortality was observed between the groups.
Conclusions:
- Adrenal adenomas are associated with a higher prevalence and incidence of adverse cardiometabolic outcomes.
- These findings highlight the importance of monitoring cardiometabolic health in patients with adrenal adenomas.
Context:
While adrenal adenomas have been linked with cardiovascular morbidity in convenience samples of patients from specialized referral centers, large-scale population-based data are lacking.
Objective:
To determine the prevalence and incidence of cardiometabolic disease and assess mortality in a population-based cohort of patients with adrenal adenomas.
Design:
Population-based cohort study.
Setting:
Olmsted County, Minnesota, USA.
Patients:
Patients diagnosed with adrenal adenomas without overt hormone excess and age- and sex-matched referent subjects without adrenal adenomas.
Main Outcome Measure:
Prevalence, incidence of cardiometabolic outcomes, mortality.
Results:
(Adrenal adenomas were diagnosed in 1004 patients (58% women, median age 63 years) from 1/01/1995 to 12/31/2017. At baseline, patients with adrenal adenomas were more likely to have hypertension [adjusted odds ratio (aOR) 1.96, 95% CI 1.58-2.44], dysglycemia (aOR 1.63, 95% CI 1.33-2.00), peripheral vascular disease (aOR 1.59, 95% CI 1.32-2.06), heart failure (aOR 1.64, 95% CI 1.15-2.33), and myocardial infarction (aOR 1.50, 95% CI 1.02-2.22) compared to referent subjects. During median follow-up of 6.8 years, patients with adrenal adenomas were more likely than referent subjects to develop de novo chronic kidney disease [adjusted hazard ratio (aHR) 1.46, 95% CI 1.14-1.86], cardiac arrhythmia (aHR 1.31, 95% CI 1.08-1.58), peripheral vascular disease (aHR 1.28, 95% CI 1.05-1.55), cardiovascular events (aHR 1.33, 95% CI 1.01-1.73), and venous thromboembolic events (aHR 2.15, 95% CI 1.48-3.13). Adjusted mortality was similar between the 2 groups.
Conclusion:
Adrenal adenomas are associated with an increased prevalence and incidence of adverse cardiometabolic outcomes in a population-based cohort.
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