Abstract
Objectives. The aim of our study was to investigate the differences in adrenal gland volume between nondiabetic controls and Type-2 diabetic patients and to examine the influence of glycemic control in diabetes mellitus on adrenal gland volume. Methods. From March 2 to November 25, 2015, 62 consecutive patients with Type-2 DM along with 62 nondiabetics matched by age, gender, and BMI were enrolled in this prospective study. Our diabetes patients were categorized into two groups, well-controlled and poorly controlled diabetes groups. Adrenal volumetric measurements were performed by two radiologists, prospectively and independently, with semiautomatic software. Interobserver reliability was studied using the interobserver correlation coefficient (ICC). Results. The total adrenal volume (TAV) was significantly higher in Type-2 diabetic patients when compared with nondiabetic patients (p < 0.05). When we investigated diabetic patients according to glycemic controls, the TAVs in controlled diabetic patients were significantly higher than in those of the poorly controlled or uncontrolled diabetic patients (p < 0.05). Nondiabetic control patients have significantly smaller TAVs when compared to controlled and poorly or noncontrolled diabetic patients (p < 0.05). Conclusion. Our study suggests that adrenal gland volume measurement may be used as an indirect marker of glycemic control in patients with diabetes.
Highlights
Diabetes mellitus (DM) is a chronic disease causing impairment of the functions of many systems, such as the cardiovascular, immune, and central nervous systems
To rule out a possible effect of BMI on adrenal volume, with use of analysis of variance (ANOVA) test we found that BMI have no statistically significant effect on adrenal volume (p = 0.377)
When we investigated diabetic patients according to glycemic controls, the total adrenal volume (TAV) in controlled diabetic patients were significantly higher than those of the poorly or uncontrolled diabetic patients (p < 0.05) (Table 4)
Summary
Diabetes mellitus (DM) is a chronic disease causing impairment of the functions of many systems, such as the cardiovascular, immune, and central nervous systems. Its effect on the central nervous system is primarily caused by affecting the functions of the hypothalamic-pituitary-adrenal (HPA) axis. The 24 h urine free cortisol (UFC) test is one of the best methods for the evaluation of the functions of the HPA axis. It was reported that adrenal gland morphology is as effective as laboratory tests for the evaluation of HPA axis function [2]. The accuracy of the results of length measurement by means of multidetector computed tomography (MDCT) to assess the size of the adrenal glands is doubtful, since it is user-dependent and prone to alteration by section thickness. Some recent studies have provided evidence that measuring adrenal volume by means of software programs using thin section MDCT images provides more reliable quantitative information [3, 4]
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