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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

06/30/2021

Pubmed ID

34185830

Pubmed Central ID

PMC8530703

DOI

10.1210/clinem/dgab468

Scopus ID

2-s2.0-85119514925 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

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 I

Author

Catherine Zhang MD Assistant Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adrenal Gland Neoplasms
Adrenocortical 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