M Araujo-Castro1, C Robles Lázaro2, P Parra Ramírez3, R García Centeno4, P Gracia Gimeno5, M T Fernández-Ladreda6, M A Sampedro Núñez7, M Marazuela7, H F Escobar-Morreale8, P Valderrabano9. 1. Neuroendocrinology Unit, Department of Endocrinology and Nutrition. Hospital, Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS. Madrid, Madrid, Spain. marta.araujo@salud.madrid.org. 2. Department of Endocrinology and Nutrition, Hospital Virgen de la Concha, Zamora, Spain. 3. Department of Endocrinology and Nutrition, Hospital Universitario la Paz, Madrid, Spain. 4. Department of Endocrinology and Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain. 5. Department of Endocrinology and Nutrition, Hospital Royo Villanova, Zaragoza, Spain. 6. Department of Endocrinology and Nutrition, Hospital Universitario de Puerto Real, Cádiz, Spain. 7. Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Madrid, Spain. 8. Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, University of Alcalá, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid, Spain. 9. Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid, Spain.
Abstract
PURPOSE: To evaluate differences between patients with unilateral and bilateral adrenal incidentalomas (AIs) in the prevalence of autonomous cortisol secretion (ACS) and related comorbidities. METHODS: In this multicentre retrospective study, AIs ≥ 1 cm without overt hormonal excess were included in the study. ACS was defined by a post-dexamethasone suppression test (DST) serum cortisol ≥ 5.0 µg/dl, in the absence of signs of hypercortisolism. For the association of ACS with the prevalence of comorbidities, post-DST serum cortisol was also analysed as a continuous variable. RESULTS: Inclusion criteria were met by 823 patients, 66.3% had unilateral and 33.7% bilateral AIs. ACS was demonstrated in 5.7% of patients. No differences in the prevalence of ACS and related comorbidities were found between bilateral and unilateral AIs (P > 0.05). However, we found that tumour size was a good predictor of ACS (OR = 1.1 for each mm, P < 0.001), and the cut-off of 25 mm presented a good diagnostic accuracy to predict ACS (sensitivity of 69.4%, specificity of 74.1%). During a median follow-up time of 31.2 (IQR = 14.4-56.5) months, the risk of developing dyslipidaemia was increased in bilateral compared with unilateral AIs (HR = 1.8, 95% CI = 1.1-3.0 but, this association depended on the tumour size observed at the end of follow-up (HR adjusted by last visit-tumour size = 0.9, 95% CI = 0.1-16.2). CONCLUSIONS: Tumour size, not bilaterality, is associated with a higher prevalence of ACS. During follow-up, neither tumour size nor bilaterality were associated with the development of new comorbidities, yet a larger tumour size after follow-up explained the association of bilateral AIs with the risk of dyslipidaemia.
PURPOSE: To evaluate differences between patients with unilateral and bilateral adrenal incidentalomas (AIs) in the prevalence of autonomous cortisol secretion (ACS) and related comorbidities. METHODS: In this multicentre retrospective study, AIs ≥ 1 cm without overt hormonal excess were included in the study. ACS was defined by a post-dexamethasone suppression test (DST) serum cortisol ≥ 5.0 µg/dl, in the absence of signs of hypercortisolism. For the association of ACS with the prevalence of comorbidities, post-DST serum cortisol was also analysed as a continuous variable. RESULTS: Inclusion criteria were met by 823 patients, 66.3% had unilateral and 33.7% bilateral AIs. ACS was demonstrated in 5.7% of patients. No differences in the prevalence of ACS and related comorbidities were found between bilateral and unilateral AIs (P > 0.05). However, we found that tumour size was a good predictor of ACS (OR = 1.1 for each mm, P < 0.001), and the cut-off of 25 mm presented a good diagnostic accuracy to predict ACS (sensitivity of 69.4%, specificity of 74.1%). During a median follow-up time of 31.2 (IQR = 14.4-56.5) months, the risk of developing dyslipidaemia was increased in bilateral compared with unilateral AIs (HR = 1.8, 95% CI = 1.1-3.0 but, this association depended on the tumour size observed at the end of follow-up (HR adjusted by last visit-tumour size = 0.9, 95% CI = 0.1-16.2). CONCLUSIONS: Tumour size, not bilaterality, is associated with a higher prevalence of ACS. During follow-up, neither tumour size nor bilaterality were associated with the development of new comorbidities, yet a larger tumour size after follow-up explained the association of bilateral AIs with the risk of dyslipidaemia.
Authors: R Rossi; L Tauchmanova; A Luciano; M Di Martino; C Battista; L Del Viscovo; V Nuzzo; G Lombardi Journal: J Clin Endocrinol Metab Date: 2000-04 Impact factor: 5.958
Authors: M Terzolo; A Stigliano; I Chiodini; P Loli; L Furlani; G Arnaldi; G Reimondo; A Pia; V Toscano; M Zini; G Borretta; E Papini; P Garofalo; B Allolio; B Dupas; F Mantero; A Tabarin Journal: Eur J Endocrinol Date: 2011-04-06 Impact factor: 6.664
Authors: Marta Araujo-Castro; César Mínguez Ojeda; María Noelia Sánchez Ramírez; Victoria Gómez Dos Santos; Eider Pascual-Corrrales; María Fernández-Argüeso Journal: Endocrine Date: 2022-06-25 Impact factor: 3.925
Authors: Marta Araujo-Castro; Paola Parra Ramírez; Cristina Robles Lázaro; Rogelio García Centeno; Paola Gracia Gimeno; Mariana Tomé Fernández-Ladreda; Miguel Antonio Sampedro Núñez; Mónica Marazuela; Héctor F Escobar-Morreale; Pablo Valderrabano Journal: J Clin Med Date: 2021-11-25 Impact factor: 4.241