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Nonalcoholic fatty liver disease in subjects with adrenal incidentaloma.
[adrenal incidentaloma]
Adrenal
incidentalomas
(
AI
)
are
associated
with
several
parameters
of
the
metabolic
syndrome
(
MS
)
.
Although
nonalcoholic
fatty
liver
disease
(
NAFLD
)
is
considered
a
cardiometabolic
risk
factor
,
no
data
exist
on
its
prevalence
and
clinical
relevance
in
AI
.
The
aim
was
to
investigate
the
presence
of
MS
and
NAFLD
in
AI
subjects
.
Fifty
-
six
AI
subjects
and
30
age-
,
sex-
and
body
mass
index
(
BMI
)
-
matched
controls
were
evaluated
.
All
subjects
underwent
abdominal
computerized
tomography
scan
and
hepatic
and
spleen
attenuation
measurements
.
The
presence
of
NAFLD
was
defined
as
a
mean
hepatic
minus
mean
spleen
attenuation
difference
(
ΔL-ΔS
)
<
-
10
HU
.
Anthropometric
variables
[
BMI
and
waist-
to
-
hip
ratio
(
W
/
H
)
]
were
recorded
,
and
biochemical
parameters
were
measured
.
An
oral
glucose
tolerance
test
was
performed
,
and
several
insulin
resistance
(
IR
)
indices
were
determined
.
All
subjects
underwent
testing
to
reveal
autonomous
cortisol
and
/
or
aldosterone
(
ALD
)
secretion
,
while
the
diagnosis
of
pheochromocytoma
was
ruled
out
.
Adrenal
incidentaloma
subjects
'
mean
age
(
±
standard
deviation
)
was
59
.
64
(
±
8
.
68
)
years
,
BMI
29
.
84
(
±
5
.
85
)
kg
/
m
(
2
)
and
W
/
H
0
.
90
(
±
0
.
07
)
.
Twelve
subjects
with
AI
had
subtle
autonomous
cortisol
,
five
autonomous
ALD
and
three
combined
cortisol
and
ALD
secretion
.
AI
subjects
exhibited
higher
IR
indices
than
controls
.
NAFLD
was
present
in
three
AI
subjects
and
two
controls
.
In
the
multiple
regression
analysis
,
W
/
H
and
triglycerides
were
independently
associated
with
a
low
ΔL-ΔS
and
,
hence
,
degree
of
hepatic
steatosis
.
There
was
no
significant
difference
in
the
presence
of
NAFLD
between
AI
patients
and
controls
.
ΔL-ΔS
,
an
inverse
index
of
NAFLD
,
was
independently
associated
with
abdominal
obesity
and
increased
triglycerides
.
Diseases
Validation
Diseases presenting
"a low δl-δs"
symptom
adrenal incidentaloma
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