Cardiometabolic Outcomes and Mortality in Patients with Adrenal Adenomas in a Population-based Setting. J Clin Endocrinol Metab 2021 Oct 21;106(11):3320-3330
Date
06/30/2021Pubmed ID
34185830Pubmed Central ID
PMC8530703DOI
10.1210/clinem/dgab468Scopus ID
2-s2.0-85119514925 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
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.
Author List
Zhang CD, Li D, Kaur RJ, Ebbehoj A, Singh S, Atkinson EJ, Achenbach SJ, Young WF, Arlt W, Rocca WA, Bancos IAuthor
Catherine Zhang MD Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Adrenal Gland NeoplasmsAdrenocortical Adenoma
Adult
Aged
Aged, 80 and over
Cardiovascular Diseases
Female
Follow-Up Studies
Humans
Male
Metabolic Diseases
Middle Aged
Minnesota
Prevalence
Prognosis
Survival Rate
Young Adult