Metabolic Abnormalities in Patients with Adrenal Incidentaloma
José-Manuel Fernández-Real,
Jose Gonzalbez and
Wifredo Ricart
Unitat de Diabetologia, Endocrinologia i Nutrició
University Hospital of Girona "Dr Josep Trueta"
17007 Girona, Spain
To the editor:
Rossi et al. (1) recently reported in
the journal an unexpectedly high prevalence of subtle autonomous
cortisol secretion, associated with high occurrence of hypertension,
diabetes mellitus, elevated lipids, and diffuse obesity in patients
with adrenal incidentaloma. The occurrence of diabetes was higher in
the group of subclinical Cushings syndrome (CS) patients (50%
vs. 26%). Glucose intolerance was further diagnosed in 2 of
12 CS patients. Arterial hypertension occurred in 91.8% of patients
with subclinical CS and in 34% of the remaining patients. In the final
part of the manuscript, the authors claim that "...the high
prevalence of hypertension and metabolic disorders found in our study
is to be confirmed by others... ." Rossi et al.
(1) diagnosed type 2 diabetes mellitus and glucose
intolerance by means of fasting glucose values (2). In the
last years, we coordinated a multicenter study of 64 consecutive
patients harboring incidental adrenal adenomas (3). The
prevalence of glucose intolerance or diabetes mellitus was determined
through an oral glucose tolerance test. The prevalence of altered
glucose tolerance was 39 of 64 (61%), well above the prevalence of
type 2 diabetes mellitus described for
Received July 11, 2000.
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