Evaluation of metabolic parameters such as prediabetes, diabetes frequency, and plasma atherogenic index in patients with adrenal incidentaloma having thyroid nodules

Thyroid nodules in patients with adrenal incidentaloma to evaluate metabolic parameters such as prediabetes, diabetes frequency, and plasma atherogenic index INTRODUCTION AND AIM: The study investigates prediabetes, diabetes, and metabolic parameters in patients with thyroid nodules and adrenal incidentalomas, correlating with diseases like diabetes, hypertension, and metabolic syndrome, prevalent in modern society. METHODS: The study included 107 patients from Sakarya University Training and Research Hospital's Endocrinology clinic between January 1, 2013, and May 30, 2023. Patients, aged 18 and over, without pregnancy, had both thyroid nodules and adrenal incidentalomas. Data on adrenal mass localization, diameter, nature, and functionality, as well as thyroid nodule localization and diameter, were collected. Additionally, thyroid function tests and metabolic parameters were obtained from hospital records. RESULTS: The mean age of patients with thyroid nodules and adrenal incidentalomas was 59.3 years, with 78% being female. Hypertension was present in 73.8% of patients, and diabetes in 25.2%. Among them, 86% had non-functional incidentalomas, 9.3% had subclinical Cushing, 3.7% had pheochromocytoma, and 0.9% had primary hyperaldosteronism. A positive correlation was found between thyroid nodule volume and fasting blood sugar and HbA1c values, but no significant relationship was observed between adrenal tumor size, thyroid nodule volume, or examined metabolic parameters. CONCLUSIONS: Our study emphasizes the common occurrence of obesity, diabetes, hypertension, and metabolic syndrome in patients with both adrenal incidentalomas and thyroid nodules. We observed an earlier onset of metabolic syndrome and its components in this group. The association between adrenal incidentalomas and thyroid nodules with hyperglycemia was independent of adrenal and thyroid hormone levels. There was no significant correlation between the volume of thyroid nodules, adrenal tumor size, and metabolic parameters. Further studies are needed to understand the relationship between adrenal incidentalomas and nodular thyroid disease. Key words: Adrenal Incidentaloma, metabolic syndrom, thyroid nodule