Investigation of telomere length in patients with non-functional adrenal incidentalomas

Aim: Telomeres play an important role in maintaining the integrity and stability of genetic material, especially during cell replication, by preventing fusions between chromosomes. Along with genetic factors, there are also environmental factors that affect telomere length. The most important of these factors are oxidative stress and inflammation. In our study, it was aimed to evaluate whether telomere length is shortened in patients with nonfunctional adrenal incidentaloma compared to the healthy control group. Materials and Methods: Our study was designed as a prospective, single-center study. A total of 44 patients with nonfunctional adrenal masses aged 40-60 years, who applied to the endocrinology and metabolism diseases outpatient clinic of our hospital, and 44 healthy controls were included in the study. Genomic DNA telomere length in peripheral blood was determined by quantitative PCR. Results: Forty-four patients with non-functioning adrenal incidentaloma (NFAI) and 44 healthy controls were compared. There was no significant difference between the groups in terms of age and sex distribution. The NFAI group had a larger waist circumference (p=0.044), a higher prevalence of hypertension (p=0.020), and lower levels of LDL cholesterol (p=0.014) and vitamin D (p=0.009). Telomere length was significantly shorter in the NFAI group (p=0.046). While no significant difference was found in telomere lengths in subgroup analyses, patients with basal ACTH levels <15 pg/ml had significantly shorter telomeres than those with basal ACTH levels ≥15 pg/ml (p=0.034). A strong positive correlation was observed only between telomere length and basal ACTH level (p=0.001). Conclusion: In conclusion, this study demonstrated a significant shortening of telomere length in patients with NFAI. These findings suggest that telomere dynamics may play a role as a potential mechanism underlying the increased cardiometabolic risk in NFAI patients. However, larger-scale studies investigating genetic, epigenetic, and environmental influences in detail are needed to better understand other potential factors affecting telomere length.