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 Cushing’s 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.

References

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