Marta Araujo-Castro1,2,3, Paola Parra Ramírez4, Patricia Martín Rojas-Marcos4, Rogelio García Centeno5, Paola Gracia Gimeno6, Mariana Tomé Fernández-Ladreda7, Miguel Antonio Sampedro Núñez8, Cecilia Higueruela9, Cristina Robles Lázaro9. 1. Endocrinology & Nutrition Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. marta.araujo@salud.madrid.org. 2. Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain. marta.araujo@salud.madrid.org. 3. University of Alcalá, Madrid, Spain. marta.araujo@salud.madrid.org. 4. Endocrinology & Nutrition Department, Hospital Universitario La Paz Madrid, Madrid, Spain. 5. Endocrinology & Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain. 6. Endocrinology & Nutrition Department, Hospital Royo Villanueva, Zaragoza, Spain. 7. Endocrinology & Nutrition Department, Hospital Universitario Puerto Real, Cadiz, Spain. 8. Endocrinology & Nutrition Department., Hospital Universitario de La Princesa, Madrid, Spain. 9. Endocrinology & Nutrition Department, Complejo Universitario de Salamanca, Salamanca, Spain.
Abstract
PURPOSE: To analyze the differences in the cardiometabolic profile in patients with nonfunctioning adrenal incidentalomas (NFAI) with post-dexamethasone suppression test (DST) cortisol ≤1.4 µg/dL (NFAI ≤ 1.4) and those with post-DST cortisol >1.4 µg/dL (NFAI > 1.4) and between NFAI with post-DST cortisol ≤0.9 µg/dL (NFAI ≤ 0.9) and those with levels >0.9 µg/dL (NFAI > 0.9). METHODS: Multicenter retrospective observational study of patients with NFAIs. NFAI was defined as an adrenal incidentaloma with negative hormonal study (including metanephrines, post-DST cortisol ≤1.8 µg/dL and aldosterone/renin ratio when screening was indicated). Autonomous cortisol secretion (ACS) development was defined as an NFAIs in which post-DST serum cortisol >1.8 µg/dL were evidenced during hormonal follow-up evaluation. RESULTS: A total of 593 NFAI were included. Based on the 1.4 µg/dL threshold in the DST, most of the NFAI were classified as NFAI ≤ 1.4 (74.5%). Patients in the NFAI > 1.4 group were older than those in the NFAI ≤ 1.4 group, but there was no difference in the cardiometabolic profile after adjusting for age. A total of 69.5% of the patients had DST > 0.9 µg/dl. They were older and had a higher prevalence of cardiovascular disease than NFAI ≤ 0.9, even after adjusting by age (adjusted OR = 2.23 [1.10-4.53]). Patients in the NFAI > 1.4 group developed ACS more commonly than the NFAI ≤ 1.4 group (23.5% vs. 7.44%, P < 0.001). However, when the threshold of 0.9 µg/dL was considered, no difference was found between NFAI ≤ 0.9 and NFAI > 0.9 (P = 0.126). CONCLUSION: The threshold of 1.4 µg/dL in the DST is useful to predict which patients with NFAI had a higher risk of ACS development during follow-up; and the threshold of 0.9 µg/dL to identify those patients with NFAI with a higher cardiovascular risk.
PURPOSE: To analyze the differences in the cardiometabolic profile in patients with nonfunctioning adrenal incidentalomas (NFAI) with post-dexamethasone suppression test (DST) cortisol ≤1.4 µg/dL (NFAI ≤ 1.4) and those with post-DST cortisol >1.4 µg/dL (NFAI > 1.4) and between NFAI with post-DST cortisol ≤0.9 µg/dL (NFAI ≤ 0.9) and those with levels >0.9 µg/dL (NFAI > 0.9). METHODS: Multicenter retrospective observational study of patients with NFAIs. NFAI was defined as an adrenal incidentaloma with negative hormonal study (including metanephrines, post-DST cortisol ≤1.8 µg/dL and aldosterone/renin ratio when screening was indicated). Autonomous cortisol secretion (ACS) development was defined as an NFAIs in which post-DST serum cortisol >1.8 µg/dL were evidenced during hormonal follow-up evaluation. RESULTS: A total of 593 NFAI were included. Based on the 1.4 µg/dL threshold in the DST, most of the NFAI were classified as NFAI ≤ 1.4 (74.5%). Patients in the NFAI > 1.4 group were older than those in the NFAI ≤ 1.4 group, but there was no difference in the cardiometabolic profile after adjusting for age. A total of 69.5% of the patients had DST > 0.9 µg/dl. They were older and had a higher prevalence of cardiovascular disease than NFAI ≤ 0.9, even after adjusting by age (adjusted OR = 2.23 [1.10-4.53]). Patients in the NFAI > 1.4 group developed ACS more commonly than the NFAI ≤ 1.4 group (23.5% vs. 7.44%, P < 0.001). However, when the threshold of 0.9 µg/dL was considered, no difference was found between NFAI ≤ 0.9 and NFAI > 0.9 (P = 0.126). CONCLUSION: The threshold of 1.4 µg/dL in the DST is useful to predict which patients with NFAI had a higher risk of ACS development during follow-up; and the threshold of 0.9 µg/dL to identify those patients with NFAI with a higher cardiovascular risk.
Authors: M P de Paula; A B Moraes; M das Graças Coelho de Souza; E M R Cavalari; R C Campbell; G da Silva Fernandes; M L F Farias; L M C Mendonça; M Madeira; E Bouskela; L G Kraemer-Aguiar; L Vieira Neto Journal: J Endocrinol Invest Date: 2020-07-19 Impact factor: 4.256
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: M Araujo-Castro; C Robles Lázaro; P Parra Ramírez; R García Centeno; P Gracia Gimeno; M T Fernández-Ladreda; M A Sampedro Núñez; M Marazuela; H F Escobar-Morreale; P Valderrabano Journal: J Endocrinol Invest Date: 2021-03-08 Impact factor: 4.256