TOPLINE:

Patients with adrenal adenoma had a higher prevalence of obesity, low socioeconomic status, tobacco use, and diabetes 5-10 years before diagnosis than control individuals with prior imaging but no adenoma. Increased BMI and tobacco use were found to be independent risk factors for the diagnosis of adrenal adenoma.

METHODOLOGY:

• Despite the detection of adrenal adenomas with imaging, little is known about the modifiable and nonmodifiable risk factors contributing to their development.
• Researchers conducted a population-based historical case-control study to identify social and metabolic risk factors associated with the development of adrenal adenoma.
• They included 670 patients with adrenal adenoma, most with unknown cortisol secretion, diagnosed between 2005 and 2017 (median age, 63.3 years; 56% women), along with two control groups: 670 age- and sex-matched individuals without adrenal adenoma (representing the general population) and 670 matched individuals with at least one prior CT/MRI imaging within 5 years of the index date but no diagnosis of adenoma.
• Data on social and metabolic risk factors (BMI, diabetes, dyslipidemia, tobacco or substance use, socioeconomic status, etc.) present 5-10 years prior to diagnosis and at the index date were collected and compared across groups.

TAKEAWAY:

• At 5-10 years prior to the index date, patients with adrenal adenoma had a higher prevalence of obesity (56.7% vs 49.3%; P = .007), low socioeconomic status (36.7% vs 31.1%; P = .039), tobacco use (70.2% vs 61.4%; P = .001), and diabetes (17.5% vs 11.7%; P = .003) than control individuals with prior imaging.
• Patients with adrenal adenoma also had a higher prevalence of substance use, tobacco use, obesity, hypertension, dyslipidemia, and diabetes than individuals representing the general population.
• At the index date, patients with adrenal adenoma had a higher prevalence of obesity, low socioeconomic status, substance use, tobacco use, prediabetes, and diabetes than control individuals with prior imaging (P < .05 for all).
• Increased BMI (per 5-unit increase) and tobacco use were independently associated with increased odds of a subsequent diagnosis of adrenal adenoma (adjusted odds ratio [aOR], 1.18; 95% CI, 1.07-1.32; and aOR, 1.41; 95% CI, 1.06-1.87; respectively).

IN PRACTICE:

“In our study, we found that increased BMI and tobacco use were independent risk factors for adrenal adenoma diagnosis. Further validation of these findings may help modify patient behaviors and reduce the impact of modifiable risk factors,” the authors wrote.

SOURCE:

This study was led by Ashley J. Han, Mayo Clinic, Rochester, Minnesota. It was published online, in European Society of Endocrinology.

LIMITATIONS:

This study included a relatively homogenous cohort of more than 90% White individuals, which may have limited generalizability of the results. The small number of patients with confirmed mild autonomous cortisol secretion prevented a robust subgroup analysis. The retrospective observational design of this study prevented the establishment of temporality or causality between risk factors and adrenal adenoma diagnosis.

DISCLOSURES:

One author reported receiving research support, consulting fees, or serving as an advisory board member with various pharmaceutical companies, as well as serving on the editorial board of a journal, outside the submitted work. This study used resources from the Rochester Epidemiology Project (REP) medical records system, supported by the National Institute on Aging, the Mayo Clinic Research Committee, and annual fees from REP users.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.