EP201 - ECE_1362 - Gender differences in adrenal disorders: a 16-year retrospective analysis of clinical and biochemical findings from Oman

Abstract Background Adrenal disorders are individually uncommon but clinically important. The incidence and prevalence of adrenal disorders in the active component of the Omani population have not been previously described. Aim To characterize the clinical, biochemical, and imaging profiles of all patients with confirmed primary adrenal disorders managed at the Royal Hospital Oman. Methods Retrospective cross-sectional situational analysis. Data retrieved from Alshifa system (Jan 2006-Dec 2022). Inclusion criteria were confirmed diagnoses of primary adrenal disorders. Patients with unconfirmed diagnoses or secondary adrenal disorders were excluded. Incidental adrenal findings not investigated were not included. Results A total of 129 patients met inclusion criteria. Mean age was 34.9 ± 22.4 years, with male predominance (63.8%). Statistical disparities included the prevalence of chronic hypokalaemia in males (14.5% of men vs 2.2% of females (P = .026). Another disparity noted is 17-hydroxyprogesterone levels were higher in women, with a mean ~201 ng/mL in females vs 51.8 ng/mL in males (P = .021). Imaging patterns showed no sex effect: computed tomography and Magnetic resonance imaging showed similar rates of adrenal mass detection. No gender disparity appeared in diagnostic imaging or tumour size. Most adrenal diagnoses were distributed similarly in males and females. Adrenal lipomas tended to be more frequent in women, but this didn't reach significance (P = .102). Among all studied adrenal disorders, most prevalent in our cohort was congenital adrenal hyperplasia (25%) followed by adrenal adenoma (17%). The mortality was higher in adrenocortical carcinoma compared to other included adrenal disorders, regardless of gender. Conclusions This 16-year analysis highlights gender differences in adrenal disorders in Oman, with CAH and adrenal adenomas being predominant. While overall disease distribution was similar between both genders, important sex-specific differences emerged: chronic hypokalaemia was more common in men, women had higher 17 hydroxyprogesterone. These results support sex-sensitive diagnostic approaches and provide baseline data to guide future research. High prevalence of CAH is likely due geographical variation, sub-analysis to investigate underlying consanguinity as contributing factor is recommended.