Abstract
OBJECTIVE: Cushing's syndrome increases the risk of cardiovascular disease. The triglyceride-glucose (TyG) index has been linked to an increased risk of cardiometabolic disorders. Whether patients with non-functioning adrenal incidentaloma (NFAI) or cortisol-secreting adrenal incidentaloma (CSAI) have altered TyG index is unknown. Therefore, we aimed to investigate the TyG index between adrenal incidentaloma patients and controls. MATERIALS AND METHODS: This cross-sectional study retrospectively included patients with NFAI, CSAI and healthy controls admitted to a tertiary endocrinology service. Subjects receiving hormone replacement, or having cancer, diabetes mellitus, alcoholism, psychiatric disorders, hepatic and/or renal insufficiency or morbid obesity were excluded. TyG index was calculated using the following formula: (Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)]/2). The primary endpoint was the difference in TyG index between patients with NFAI, CSAI and healthy controls. RESULTS: A total of 142 patients with incidentaloma [NFAI, n=95, age: 60.9±10.6 years, women: 75.8%; CSAI, n=47, age: 59.6±13.7 years, women: 63.8%] and 116 age and sex matched healthy controls (age: 59.8±13.4 years, women: 76.7%) were evaluated. Compared with healthy controls, patients with overall incidentaloma, NFAI and CSAI had increased TyG index (6.39±1.87 vs. 8.85±0.52, 8.76±0.25, and 8.81±0.51, respectively, P<0.001 for all). There was no difference in TyG index between patients with NFAI and CSAI (8.76±0.25 vs. 8.81±0.51), and with possible autonomous cortisol secretion, autonomous cortisol secretion and Cushing's syndrome (8.80±0.54, 8.86±0.52 and 9.31±0.37). CONCLUSION: This study showed increased TyG index in patients with NFAI or CSAI, emphasizing the importance of cardiometabolic risk assessment in patients with adrenal incidentaloma even if it is non-functioning.