Cardiometabolic Risk in Bilateral versus Unilateral Nonfunctioning Adrenal Incidentalomas: Evidence From a Large...

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Oncology

Background:

• Nonfunctioning adrenal incidentalomas (NFAIs) are common adrenal tumors.
• The cardiometabolic risk associated with NFAIs is not fully understood.
• Distinguishing risk between unilateral and bilateral NFAIs is crucial.

Purpose of the Study:

• To compare cardiovascular risk and related complications in patients with bilateral versus unilateral NFAIs.
• To investigate the association between bilaterality of NFAIs and cardiometabolic outcomes.

Main Methods:

• Retrospective cross-sectional study of 906 patients with NFAIs.
• Cardiovascular risk assessed using Framingham, CUORE, SCORE, and SCORE-2 scores.
• Data collected on cardiometabolic complications and organ damage.

Main Results:

• Bilateral NFAIs were associated with significantly higher cardiovascular risk scores compared to unilateral NFAIs.
• Patients with bilateral NFAIs had increased odds of type 2 diabetes mellitus (OR 2.36) and organ damage (OR 2.09).
• Adjustments were made for multiple confounding factors including age, sex, BMI, and hypertension.

Conclusions:

• Bilateral NFAIs represent a distinct clinical phenotype with greater cardiometabolic risk.
• These findings suggest bilateral NFAIs warrant closer cardiometabolic monitoring.
• Further research into the specific mechanisms driving this increased risk is warranted.