{'fraction_non_alphanumeric': 0.054865424430641824, 'fraction_numerical': 0.043478260869565216, 'mean_word_length': 5.19551282051282, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
NONFUNCTIONING ADRENAL INCIDENTALOMAS ARE NOT CLINICALLY SILENT: A LONGITUDINAL COHORT STUDY.

Objective: The association between nonfunctioning adrenal incidentalomas (NFAIs) and cardiometabolic diseases remains controversial. This retrospective cohort study investigated whether NFAIs are related with prevalent and incident cardiometabolic diseases. Methods: This study included 154 patients with biochemically confirmed NFAIs and 1:3 age and sex-matched controls without AIs (n=462) among subjects who underwent abdominal computed tomography at a single healthcare center in 2003-2012. Electronic medical records were reviewed for comorbidities at baseline and during a mean follow-up of 7.5 years. The logistic regression analysis for prevalent cardiometabolic diseases and the survival analysis for incident cardiometabolic diseases were performed. Results: The subjects were 55.7±8.8 years of age and predominantly male (73.1%). The NFAI group had a higher BMI compared to the age and sex-matched control group (25.1±2.8 vs. 24.0±2.8 kg/m2, P<0.001). In cross-sectional design, covariate-adjusted logistic regression showed significantly higher odds ratios (ORs) for diabetes mellitus and hypertension in the NFAI group (adjusted ORs [95% confidence interval (CI)], 1.89 [1.17-3.06] and 2.26 [1.47-3.50], respectively). The NFAI group had a two-fold higher risk of insulin resistance (adjusted ORs [95%CI], 2.03 [1.06-3.90]). Moreover, NFAI subjects with diabetes mellitus had a greater increase in size of adrenal lesions than those without diabetes mellitus (3.4±5.5 vs. 1.4±5.5 mm, P=0.048). However, in the survival analysis, the incidence of any cardiometabolic diseases did not differ between the NFAI and control groups. Conclusion: NFAIs are related to prevalent diabetes mellitus or hypertension in the cross-sectional study. However, the presence of NFAIs did not affect the development of cardiometabolic diseases.