Association between CT-based adrenal gland volume and 10-year cardiovascular disease risk in patients with diabetes mellitus

Background: Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis is an independent risk factor for cardiovascular disease (CVD). Adrenal gland volume reflects disturbances in glucose-lipid metabolism and HPA axis activity, but its relationship with CVD risk remains unclear. This study aimed to investigate the association between adrenal gland volume and estimated 10-year CVD risk in patients with diabetes mellitus (DM). Methods: A total of 223 patients with DM (30-74 years) without prior CVD were retrospectively included. Adrenal gland volume was measured from non-contrast computed tomography (CT) images using a three-dimensional no new U-net (nnU)-Net deep learning algorithm. The 10-year CVD risk was estimated using the Framingham Risk Score (FRS) and categorized into low-to-intermediate risk (