The Risk of T2D in Individuals With Benign Adrenal Tumors

Adrenal gland tumors that are defined as being nonfunctional may not really be so, and the hormones that these tumors secrete could increase an individual’s risk of cardiometabolic irregularities, according to a new study published in Annals of Internal Medicine.

Tumors in the adrenal glands—abdominal glands that produce hormones and are included in the endocrine system—are classified as benign, functional, and malignant. The benign tumors are typically defined as being noncancerous and are found by chance when diagnostic tests are being conducted to evaluate some other symptoms. However, one of the hormones secreted by these tumors is cortisol, which can increase the risk of cardiovascular and metabolic diseases.

To further study the relation between the development of these tumors and an individual’s risk for cardiometabolic outcomes, researchers conducted a retrospective analysis of medical data gathered from 166 individuals who were documented as having developed the tumors. The control group of 740 individuals did not have adrenal tumors; inclusion criteria was a 3-year follow up period. Patient records were evaluated for an average period of 7.7 years, from the time of abdominal imaging following incidental outcomes of hypertension, composite diabetes (prediabetes or type 2 diabetes [T2D]), hyperlipidemia, cardiovascular events, or chronic kidney disease.

When the association between exposure status and incident outcomes was analyzed, it was discovered that individuals with the benign tumors had significantly higher risk for incident composite diabetes than those without the tumors. Specifically, 27.3% of those carrying the tumors had an absolute risk of 15.6% (95% CI, 6.9% to 24.3%) and an adjusted risk ratio of 1.87 (CI, 1.17 to 2.98). On the other hand, less than half (11.7%) the participants in the control group developed the risk of composite diabetes. While there was no significant association between non-functional adrenal tumors and any of the other cardiovascular outcomes being evaluated, cortisol levels were found associated with the size of the tumors and higher prevalence of T2D.

“Our results indicated that patients with non-functional adrenal tumors developed diabetes twice as often as patients without any adrenal tumors. This suggests that even adrenal tumors we deem to have no health risks are in fact associated with an increased risk of developing diabetes,” said Anand Vaidya, MD, MMSc, senior author on the study, in a statement. He recommends that adrenal tumors sould be considered a potential risk factor for the development of diabetes.

Reference

Lopez D, Luque-Fernandez MA, Steele A, Adler GK, Turchin A, Vaidya A. “Nonfunctional” adrenal tumors and the risk for incident diabetes and cardiovascular outcomes: a cohort study [published online August 2, 2016]. Ann Intern Med. doi: 10.7326/M16-0547.