Abstract Disclosure: X. Li: None. H. Lan: None. J. Wen: None. G. Chen: None. W. Lin: None. The Effects of Non-functioning Adrenal Incidentalomas on Metabolic Comorbidities and Clinical Characteristics Changes: A Systematic Review and Meta-analysis. Context: Adrenal incidentalomas (AI) are frequently detected during abdominal imaging, with non-functioning adrenal incidentalomas (NFAI) being particularly common, even in elderly individuals. This meta-analysis investigates the influence of NFAI on metabolic comorbidities, comparing non-surgical and surgical patient groups, and assessing alterations in NFAI characteristics. Design: Our comprehensive meta-analysis utilized data from multiple databases, encompassing studies from January 2000 to August 21, 2023.Setting: Data sources included PubMed, Embase, Cochrane Library, and Web of Science. Participants: The analysis comprises 24 articles involving 2,770 NFAI patients, categorized into non-surgical and surgical groups. Intervention: The non-surgical group underwent no surgery, while the surgical group underwent tumor resection. Main Outcome Measure: The study investigated changes in metabolic comorbidities (hypertension, diabetes, obesity, lipid metabolism disorders), tumor characteristics, and hormone production in NFAI patients during follow-up or after surgery. Results: In the non-surgical NFAI patient group (20 studies), metabolic comorbidities exhibited a discernible upward trajectory during follow-up. The initial hypertension prevalence of 58.3% increased by 4.2% over a 4-5 year follow-up period. Moreover, diabetes, obesity, and lipid metabolism disorders experienced significant increases of 5.8%, 2.2%, and 8.8%, respectively. In contrast, the surgical group (6 studies) demonstrated a notable reduction in hypertension, with 43.9% of initially hypertensive patients achieving hypertension-free status after surgery. As for tumor changes in the non-surgical group, they were generally inconsequential, with only 5% of patients witnessing tumor growth exceeding 10mm over approximately 3.3 years, and 8% undergoing functional changes. These findings underscore the divergent impact of non-surgical and surgical interventions on metabolic comorbidities in NFAI patients. Conclusion: The study advocates for regular monitoring of blood glucose and blood pressure in NFAI patients, especially those with metabolic comorbidities. When necessary, adenoma resection should be considered. Further investigation is warranted to elucidate the mechanisms connecting NFAI with metabolic factors. Presentation: 6/1/2024
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