Aim: We evaluated cardiovascular (CV) risk stratification for nonfunctioning adrenal incidentalomas (NFAIs) via the coronary-artery-calcium (CAC) score.

Materials and Methods: The participants were patients with NFAI (n = 55). They were compared to patients with chest pain, a low-intermediate Framingham-risk score, and a non-diagnostic treadmill- exercise test, which served as the control group (n = 49). Subsequently, the NFAI group was subdivided according to a CAC score of <100 Agatston units – mild coronary-artery calcification (n = 40) – and ≥100 Agatston units – moderate-to-severe calcification (n = 15).

Results: Similar rates of traditional risk factors were observed between the NFAI and control groups, and lower low-density lipoprotein cholesterol rates were observed in the NFAI group. The CAC score was significantly higher for the NFAI group than the control group. Glucose, potassium, adrenocorticotropic-hormone, and basal-cortisol levels were higher in those with a CAC score of ≥100. High-density-lipoprotein cholesterol estimated glomerular filtration rate and ejection fraction (EF) were higher in those with a CAC score of <100. Adenoma size and location were similar between the groups. Age, EF, and glucose were the most significant variables related to CAC score in patients with NFAI, at ≥100 Agatston units.

Discussion: Patients with a low-intermediate CV risk profile and NFAI have a higher risk of atherosclerosis when compared to patients with a low-intermediate CV risk profile, but no NFAI.

Conclusion: In patients with NFAI, CAC score evaluation may be used to predict increased atherosclerosis, especially in patients of an older age with higher glucose and decreased EF.

目的：我们通过冠状动脉钙 (CAC) 评分评估了无功能肾上腺偶发瘤 (NFAI) 的心血管 (CV) 风险分层。

材料和方法：参与者是 NFAI 患者（n = 55）。将他们与胸痛、中低弗雷明汉风险评分和非诊断性跑步机运动测试的患者进行比较，后者作为对照组（n = 49）。随后，根据 CAC 评分<100 Agatston 单位——轻度冠状动脉钙化（n = 40）——和≥100 Agatston 单位——中度至重度钙化（n = 15）对 NFAI 组进行细分。

结果：在 NFAI 组和对照组之间观察到的传统危险因素发生率相似，在 NFAI 组中观察到较低的低密度脂蛋白胆固醇率。NFAI 组的 CAC 评分显着高于对照组。CAC 评分≥100 的患者的葡萄糖、钾、促肾上腺皮质激素和基础皮质醇水平较高。CAC 评分 <100 的患者的高密度脂蛋白胆固醇估计肾小球滤过率和射血分数 (EF) 较高。各组之间的腺瘤大小和位置相似。年龄、EF 和血糖是与 NFAI 患者 CAC 评分相关的最重要变量，≥100 Agatston 单位。

讨论：与具有中低 CV 风险但没有 NFAI 的患者相比，具有中低 CV 风险和 NFAI 的患者发生动脉粥样硬化的风险更高。

结论：在NFAI患者中，CAC评分评估可用于预测动脉粥样硬化的增加，尤其是对于高血糖和EF降低的高龄患者。