Key result
Adrenal incidentalomas were found in 7.3% of 601 unselected outpatients undergoing abdominal CT and were significantly associated with an increased risk of type 2 diabetes (P=0.003).
Why the study?
The frequency of adrenal incidentalomas and their association with comorbid conditions have mostly been assessed in retrospective studies prone to ascertainment bias.
Are adrenal incidentalomas associated with an increased risk of diabetes in unselected outpatients?
Cohort (n=601)
No
Are adrenal incidentalomas associated with an increased risk of diabetes in unselected outpatients?
p-value: p=.003
Adrenal incidentalomas are relatively common (7.3%) in unselected patients undergoing abdominal CT and are independently associated with an increased risk of type 2 diabetes.
May prompt diabetes screening with adrenal incidentalomas; leaves open causality and requires prospective confirmation.
CONTEXT: The frequency of adrenal incidentalomas and their association with comorbid conditions have been assessed mostly in retrospective studies that may be prone to ascertainment bias. OBJECTIVE: The objective of this work is to evaluate the frequency of adrenal incidentalomas and their associated comorbid conditions. DESIGN: A prospective cohort study was conducted. SETTING: This study took place at a radiology department at a public hospital. PARTICIPANTS: Unselected outpatients who underwent an abdominal computed tomography (CT) from January 2017 to June 2018. Patients with known or suspected adrenal disease or malignancy were excluded. EXPOSURE: All abdominal CT scans were evaluated by an experienced radiologist. Hormonal workup including a 1-mg dexamethasone suppression test was performed in patients bearing adrenal incidentalomas. MAIN OUTCOME AND MEASURE: Frequency of adrenal incidentalomas in abdominal CT of unselected patients; frequency of comorbid conditions, and hormonal workup in patients bearing adrenal incidentalomas. RESULTS: We recruited 601 patients, and in 7.3% of them an adrenal tumor was found serendipitously. The patients bearing an adrenal incidentaloma had higher body mass index (P = .009) and waist circumference (P = .004) and were more frequently diabetic (P = .0038). At multivariable regression analysis, diabetes was significantly associated with the presence of adrenal incidentalomas (P = .003). Autonomous cortisol secretion was observed in 50% of patients who did not suppress cortisol less than 50 nmol/L after 1 mg dexamethasone. CONCLUSIONS: The frequency of adrenal incidentalomas is higher than previously reported. Moreover, adrenal incidentalomas are tied to increased risk of type 2 diabetes. This finding is free from ascertainment bias because patients with adrenal incidentalomas were drawn from a prospective cohort with the same risk of diabetes as the background population.
No takes yet. Share an insight, caveat, or question.
Reimondo et al. (2020) conducted a cohort in Adrenal incidentalomas (n=601). Presence of adrenal incidentalomas vs. Absence of adrenal incidentalomas was evaluated on Frequency of adrenal incidentalomas in abdominal CT of unselected patients; frequency of comorbid conditions (p=.003). Adrenal incidentalomas were found in 7.3% of 601 unselected outpatients undergoing abdominal CT and were significantly associated with an increased risk of type 2 diabetes (P=0.003).
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: