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Cardiometabolic Risk Parameters in "Nonfunctioning" Adrenal Incidentalomas: A Systematic Review and Meta-analysis.

Vittoria Favero1,2, Davide Bernasconi3,4, Alessandro Maloberti5,6

  • 1Department of Medical Biotechnology and Translational Medicine, University of Milan, 20100 Milan, Italy.

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Summary
This summary is machine-generated.

Patients with non-functioning adrenal incidentalomas (NFAI) exhibit elevated cardiometabolic risk markers. This systematic review and meta-analysis confirms increased cardiovascular risk in NFAI patients compared to controls.

Keywords:
HOMA-IRadrenal incidentalomascortisolinsulin resistanceintima-media thickness

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Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Radiology

Background:

  • Non-functioning adrenal incidentalomas (NFAI) are adrenal tumors discovered incidentally.
  • The potential cardiometabolic risk associated with NFAI remains incompletely understood.
  • Previous studies suggest surrogate markers of cardiovascular risk may differ in NFAI patients.

Purpose of the Study:

  • To systematically review and meta-analyze literature evaluating cardiometabolic risk in NFAI patients.
  • To compare augmentation index (AIx), carotid intima-media thickness (cIMT), flow-mediated dilation (FMD), insulin resistance (IR), left ventricular mass index (LVMI), and pulse wave velocity (PWV) in NFAI versus non-AI patients.

Main Methods:

  • Systematic review and meta-analysis of published studies.
  • Inclusion of studies comparing cIMT and IR (primary outcomes), and AIx, FMD, LVMI, PWV (secondary outcomes) in NFAI vs. matched controls.
  • Random-effects model (DerSimonian and Laird) to calculate standardized mean difference (SMD) and 95% Confidence Intervals (95%CI).

Main Results:

  • Analysis included 21 studies with 2228 subjects (mean age 53.3 years, 35% males).
  • Statistically significant differences were observed in cIMT, IR, AIx, FMD, LVMI, and PWV between NFAI patients and controls.
  • Specific SMD and 95%CI values highlight the direction and magnitude of these differences for each parameter.

Conclusions:

  • Patients with NFAI demonstrate altered levels of key cardiovascular risk parameters.
  • Findings suggest that NFAI may be associated with an increased cardiovascular risk profile.
  • Further research is warranted to elucidate the clinical implications of these findings.