Universidade Federal do Rio de Janeiro - Rio de Janeiro - Brazil

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Universidade Federal do Rio de Janeiro - Rio de Janeiro - Brazil Evaluation of the frequency of metabolic syndrome (MS) in patients with non-functioning adrenal incidentalomas (NFAI) using criteria of the NCEP and IDF Emanuela Cavalari, Mariana Arruda, Marcela Pessoa, Fernanda Ribeiro, Caroline Coelho, Felipe Morais, Aline Moraes and Leonardo Vieira Neto Universidade Federal do Rio de Janeiro - Rio de Janeiro - Brazil

AIM It is known that the prevalence of metabolic syndrome in different populations is highly dependent on the criteria used for its definition and the characteristics of the study population. The two most used criteria to define metabolic syndrome are the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF). There is no consensus on the best definition of metabolic syndrome. Despite the frequency of obesity and metabolic syndrome to be adequately studied in patients with subclinical Cushing's syndrome the same does not occur with non-functioning adrenal incidentalomas (NFAI).

OBJECTIVE To evaluate the frequency of metabolic syndrome in accordance with the NCEP and IDF criteria for patients with NFAI and the control group.

DESIGN AND SETTING Retrospective study with the collection of clinical and laboratory data of patients diagnosed with NFAI followed up in the outpatient clinic of a University Hospital. The diagnosis of NFAI was established after exclusion of hormonal activity according to current guidelines. All subjects were derived from the same university hospital and categorized by the presence or absence of metabolic syndrome according to the NCEP and IDF criteria.

PATIENTS We evaluated 69 NFAI patients and compared with 64 controls. The control group was selected having obligatory normal adrenal (proven by computed tomography or magnetic resonance imaging). The mean age in the NFAI group was 54.0±9.64 while the control group was 55.0±13.22 years. The mean body mass index (BMI) in the NFAI group was 30.45±5.78 while the control group was 29.04±6.08 kg/m2.

MEASUREMENTS AND MAIN RESULTS 40.0 38.0 36.0 34.0 32.0 30.0 28.0 26.0 24.0 22.0 20.0 18.0 40 38 36 34 32 30 28 26 24 22 20 18 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 1 55.0 ± 13.22 54.0 ± 9.64 29.0 ± 6.0

40 38 36 34 32 30 28 26 24 22 20 18 40 38 36 34 32 30 28 26 24 22 20 18 80 70 60 50 40 30 20 10 1 55 ± 13.2 54 ± 9.6 29 ± 6.0

p= 0.13 p= 0.08 p= 0.10 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 82.6 71.8 66.6 62.5 46.7 44.7

p= 0.06 99.9 ± 13.05 95.6 ± 12.93 102.0 100.0 98.0 96.0 94.0 92.0 90.0 88.0 86.0 84.0 82.0 80.0

76.5 74.2 48.2 44.0

CONCLUSION Metabolic syndrome is a frequent finding in patients with NFAI and this frequency is greater in patients with NFAI than in individuals with normal adrenal in accordance with both NCEP and IDF. Despite the NFAI is considered non-functioning, we cannot rule out the hypothesis that exists a minimal hormonal secretion not detectable by diagnostic methods currently utilized that is responsible for the increased frequency of metabolic syndrome.