Urine-normetanephrine, a predictor of mortality risk in patients with adrenal adenomas

Abstract Urine-metanephrines are used in the screening for pheochromocytomas in patients with adrenal incidentalomas, but their potential as markers for mortality in patients with adrenal adenomas has not been studied. A retrospective cohort study was designed to investigate if urine-metanephrines w...

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Main Authors: Albin Kjellbom, Magnus Löndahl, Malin Danielsson, Henrik Olsen, Ola Lindgren
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-94951-w
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author Albin Kjellbom
Magnus Löndahl
Malin Danielsson
Henrik Olsen
Ola Lindgren
author_facet Albin Kjellbom
Magnus Löndahl
Malin Danielsson
Henrik Olsen
Ola Lindgren
author_sort Albin Kjellbom
collection DOAJ
description Abstract Urine-metanephrines are used in the screening for pheochromocytomas in patients with adrenal incidentalomas, but their potential as markers for mortality in patients with adrenal adenomas has not been studied. A retrospective cohort study was designed to investigate if urine-metanephrines were associated with mortality in patients with adrenal adenomas. Participants where consecutively included between 2005 and 2015 at two endocrine centres in southern Sweden and followed until December 31st, 2022. The exposures were 24 h-urine (tU) metanephrine and normetanephrine analysed at inclusion. The endpoint was all-cause mortality. Outcome data were obtained from the Cause of Death Register. 879 adult (≥ 18 years) patients with an incidentally discovered adrenal adenoma were included in the study and followed for a median of 9.9 years. Median age of patients was 66.7 years, and 59.6% were women. 278 patients died during follow-up. tU-normetanephrine was associated with increased mortality, adjusted hazard ratio (HR) 1.47 (95% CI, 1.27–1.69) (HR for an increase of 100 μmol/mol creatinine). There was no significant association between tU-metanephrine and mortality, HR 0.96 (0.64–1.43). tU-normetanephrine seems to be a predictor for mortality in patients with adrenal adenomas. This widely available diagnostic test may be helpful in further risk-stratifying patients with adrenal adenomas.
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spelling doaj-art-835f6c554fb944109d5c09e57d0f00c52025-08-20T03:07:41ZengNature PortfolioScientific Reports2045-23222025-04-011511910.1038/s41598-025-94951-wUrine-normetanephrine, a predictor of mortality risk in patients with adrenal adenomasAlbin Kjellbom0Magnus Löndahl1Malin Danielsson2Henrik Olsen3Ola Lindgren4Department of Clinical Sciences, Faculty of Medicine, Lund UniversityDepartment of Clinical Sciences, Faculty of Medicine, Lund UniversityDepartment of Clinical Sciences, Faculty of Medicine, Lund UniversityDepartment of Clinical Sciences, Faculty of Medicine, Lund UniversityDepartment of Clinical Sciences, Faculty of Medicine, Lund UniversityAbstract Urine-metanephrines are used in the screening for pheochromocytomas in patients with adrenal incidentalomas, but their potential as markers for mortality in patients with adrenal adenomas has not been studied. A retrospective cohort study was designed to investigate if urine-metanephrines were associated with mortality in patients with adrenal adenomas. Participants where consecutively included between 2005 and 2015 at two endocrine centres in southern Sweden and followed until December 31st, 2022. The exposures were 24 h-urine (tU) metanephrine and normetanephrine analysed at inclusion. The endpoint was all-cause mortality. Outcome data were obtained from the Cause of Death Register. 879 adult (≥ 18 years) patients with an incidentally discovered adrenal adenoma were included in the study and followed for a median of 9.9 years. Median age of patients was 66.7 years, and 59.6% were women. 278 patients died during follow-up. tU-normetanephrine was associated with increased mortality, adjusted hazard ratio (HR) 1.47 (95% CI, 1.27–1.69) (HR for an increase of 100 μmol/mol creatinine). There was no significant association between tU-metanephrine and mortality, HR 0.96 (0.64–1.43). tU-normetanephrine seems to be a predictor for mortality in patients with adrenal adenomas. This widely available diagnostic test may be helpful in further risk-stratifying patients with adrenal adenomas.https://doi.org/10.1038/s41598-025-94951-wAdrenal adenomaAdrenal incidentalomaCatecholaminesMetanephrines
spellingShingle Albin Kjellbom
Magnus Löndahl
Malin Danielsson
Henrik Olsen
Ola Lindgren
Urine-normetanephrine, a predictor of mortality risk in patients with adrenal adenomas
Scientific Reports
Adrenal adenoma
Adrenal incidentaloma
Catecholamines
Metanephrines
title Urine-normetanephrine, a predictor of mortality risk in patients with adrenal adenomas
title_full Urine-normetanephrine, a predictor of mortality risk in patients with adrenal adenomas
title_fullStr Urine-normetanephrine, a predictor of mortality risk in patients with adrenal adenomas
title_full_unstemmed Urine-normetanephrine, a predictor of mortality risk in patients with adrenal adenomas
title_short Urine-normetanephrine, a predictor of mortality risk in patients with adrenal adenomas
title_sort urine normetanephrine a predictor of mortality risk in patients with adrenal adenomas
topic Adrenal adenoma
Adrenal incidentaloma
Catecholamines
Metanephrines
url https://doi.org/10.1038/s41598-025-94951-w
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