Highlights
- •Adrenal incidentalomas (AIs) have recently been on the rise.
- •This phenomenon could be highly associated with the respective rise in obesity.
- •Ιnsulin resistance, hyperinsulinemia and its anabolic effects on adrenal glands offer possible pathophysiological links.
- •Continuous headway in the field of radiology could very possibly be accountable too.
- •Reversly, patients with AIs and autonomous cortisol secretion may develop insulin resistance and obesity.
Abstract
An adrenal incidentaloma (AI) is an adrenal mass incidentally found via a radiological
modality, independent of an endocrinological investigation. In this review, we aimed
to investigate the possible reasons behind the increased frequency in AI detection,
especially in ageing populations. The pathophysiological effects of insulin resistance
(IR), hyperinsulinemia and various anabolic pathways are analyzed. In addition, we
review data from studies indicating an increased incidence of adrenal adenomas and
carcinomas in patients with type 2 diabetes mellitus (T2DM). The establishment of
obesity as a global epidemic, with a higher prevalence in the female than in the male
population, coincide with data regarding AIs and the conditions may share a pathophysiological
basis. Furthermore, we discuss the bidirectional association of AIs with obesity,
insulin resistance and T2DM, especially in patients with autonomous cortisol secretion.
Lastly, as per the definition of an AI, we touch upon the evolution of radiological
imaging as another possible cause of the rise in prevalence of AIs, especially concerning
the greater use and precision of computed tomography (CT).
Keywords
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Article info
Publication history
Published online: December 05, 2018
Accepted:
December 4,
2018
Received in revised form:
November 30,
2018
Received:
October 12,
2018
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© 2018 Elsevier B.V. All rights reserved.
