Polimorfizmi gena za glukokortikoidne receptore i rizik metaboličkoga sindroma u bolesnika s incidentalomom nadbubrežne žlijezde

Adrenal incidentalomas (AI) have been associated with an increased prevalence of arterial hypertension (AH), obesity, dyslipidemia and diabetes (DM). We aimed to investigate whether glucocorticoid receptor gene polymorphisms (BclI, N363S and ER22/23EK) were associated with the risk of metabolic syndrome (MetS) and its components in patients with AI. Consecutive patients with AI were enrolled. The presence of DM, AH, dyslipidemia and obesity was assessed. 1mg- dexamethasone suppression test was performed to diagnose autonomous cortisol secretin (ACS). DNA samples were genotyped for polymorphisms BclI, N363S and ER22/23EK. There were 103 patients (M 29.1%, aged 59.17 ±10.31yrs). 69.9% pts had AH, 14.6% DM, 46.6% dyslipidaemia and 74.8% were obese. MetS was diagnosed in 57.3% pts. ACS was found in 50.5% pts. In pts with AI polymorphism N363S was overrepresented (χ 2=12.05, p<0.001). The frequency of BclI and ER22/23 was similar as in the control population (χ 2=0.48, p=0.48 and χ 2=0.01, p=0.93, respectively). We found no differences in comorbidities nor in hormonal status between wild type and polymorphism carriers. In AI patients, GR polymorphisms BclI, N363S and ER22/23EK were not associated with the risk of MetS nor its components: AH, DM, obesity, and dyslipidaemia.