LAUSR

Abstract Incidental adrenal adenoma (AI) may be a marker for other illnesses, especially cardiovascular diseases. However, most of these studies have included men and women with mean ages >50 yrs. AI in reproductive age women has not been investigated. The purpose of this study is to identify significant associations with other co-morbidities in young women with AIs. We designed a case control study of women (ages 18 to 41) with an AI identified on CT scan for non-adrenal related issues. Similar age women receiving a CT scan without the identification of AI were employed as controls. The study was conducted in a large community health network that utilized electronic medical records between 2010 and 2017. Various patient characteristics and comorbidities were identified. Comparison between cases and controls were performed using t-test or Chi-squared test as appropriate. Bonferroni correction was applied for multiple measurements. We also reviewed the number of AI patients that underwent a work up for their adenoma. This study was approved by our IRB. We identified 100 AIs during the time period. These were compared to 100 controls (Con). The mean AI age was 32 ± 4.7 and Con 32 ± 6.3 yrs. Mean AI BMI was 36 ± 9.5 and Con 30 ± 7.9 Kg/m2 (p <0.001). The mean AI was 18.1 ± 9.4 mm, with 35% >20 mm. The AI was left-sided in 65, right-sided in 31, and bilateral in 4 (p <0.001). We found the following significant associations in AI patients: active tobacco use (AI; 45%, Con; 25%, p =0.005), hypertension (AI: 32%, Con; 12%, p =0.001) and hyperlipidemia (AI; 27%, Con; 8%, p<0.001). Although we noted higher incidence of diabetes (AI: 14% v Con: 6%,), asthma (AI: 25% v Con: 16%), endometriosis (A:I 11% v Con: 4%), and PCOS (AI: 9% v Con: 3%) in women with AI, they did not reach significance in our sample size. The AIs were worked up for functionality in a total of 8/100 women. As in studies of older males and females, AI in reproductive age women was associated with obesity and hypertension. Although correlation with DM was not noted, this may be related to younger age of our cases than in prior studies. Whether these co-morbidities are a result of obesity alone is unclear. The association with smoking, hyperlipidemia, and left side location in AI remains to be determined. Furthermore, few AIs, even those > 2 cm, were assessed for functional status. Thus, educational programs emphasizing current recommendation for evaluation of an AI may be beneficial.