Abstract


AIM: It is known that the prevalence of metabolic syndrome (MS) 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 MS are the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF). There is no consensus on the best definition of MS. view more

AIM: It is known that the prevalence of metabolic syndrome (MS) 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 MS are the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF). There is no consensus on the best definition of MS. Despite the frequency of obesity and MS to be adequately studied in patients with subclinical Cushing's syndrome subclinical the same does not occur with non-functioning adrenal incidentalomas (NFAI). OBJECTIVE: To evaluate the frequency of MS 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. The control group was selected having obligatorily normal adrenal (proven by computed tomography or magnetic resonance imaging). All subjects were derived from the same university hospital and categorized by the presence or absence of MS according to the NCEP and IDF criteria.

PATIENTS: We evaluated 69 NFAI patients and compared with 64 controls. 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: The groups were comparable for sex (p=0.13), age (p=0.12), BMI (p=0.17), smoking (0.10), race (0.08) and abdominal-hip circumference ratio (p=0.18). Despite the high frequency of changes on glucose metabolism (prediabetes and type 2 DM) in the control group, they were significantly lower when compared to the NFAI group: 51.56 vs. 78.26%, respectively (p=0.001). The frequency of dyslipidemia in the control and NFAI groups was 56.45 and 77.41%, respectively (p=0.01). The frequency of MS in the control and NFAI groups was 44.06 and 74.24% (p=0.001) according to NCEP criteria, and 48.27 and 76.56% (p=0.001) according to IDF criteria, respectively.

CONCLUSION: MS is a frequent finding in patients with NFAI and this frequency is greater in patients with IANF than in individuals with normal adrenal in accordance with both NCEP and IDF. Despite the NFAIF 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 MS.

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