| Summary: | <b>Background:</b> Compared to the general population, among people with adrenal incidentalomas (AIs) the diagnosis of obesity, hypertension, impaired carbohydrate and lipid metabolism is more common. The aformentioned disorders represent typical cardiovascular remodeling risk factors. The study was designed to assess the association between NFAIs, metabolic profile and carotid intima-media thickness (CIMT) as the predictive factor of atherosclerosis. <b>Material:</b> The study included 48 patients with NFAI (16 men, 32 women, mean age 58.6 +/− 9 years) and 44 control participants (15 men, 29 women, mean age 57 +/− 7 years). Both groups were matched for age, gender and BMI. Subjects with history of myocardial infarction, stroke or diabetes mellitus (DM) were excluded. Participants underwent adrenal imaging, biochemical evaluation, and measurement of CIMT. Hormonal evaluation was conducted in AI patients. <b>Results:</b> The NFAI group had significantly higher waist circumference (<i>p</i> < 0.01), higher systolic (<i>p</i> < 0.01) and diastolic blood pressure (<i>p</i> < 0.01), fasting insulin (<i>p</i> = 0.03) and glucose in the 2 h OGTT (<i>p</i> = 0.04) as well as higher CIMT (<i>p</i> < 0.01). Hypertension (<i>p</i> < 0.01) and IGT (<i>p</i> = 0.026) were more common in this group as well. There was a positive correlation between CIMT and cortisol levels in 1 mg dexamethasone suppression test (r = 0.33, <i>p</i> = 0.02). <b>Conclusions:</b> Patients diagnosed with NFAIs, despite normal cortisol inhibition in the 1 mg dexamethasone test, still presented a number of metabolic abnormalities. The assessment of IMT may proove valuable in indicate the presence of early vascular remodelling in asymptomatic patients. The underlying mechanisms of these findings are still unknown, hence further studies are required.
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