Association between thyroid function and serum cortisol in cortisol-producing adenoma patients
Abstract
Purpose Thyroid dysfunction has been reported in hypercortisolism. Previous findings regarding changes in thyroid function due to cortisol-producing adenoma (CPA) have been inconsistent. The study aimed to investigate the association between thyroid function and excessive cortisol secretion in patients with CPA and to explore the changes in pituitary function after adrenalectomy.Methods We conducted a retrospective study; thyroid function was evaluated in 94 patients with CPA and 94 healthy controls (HC) matched for age and sex. A total of 94 patients with nonfunctioning adrenal incidentalomas (NFAIs) were recruited as a second control group.Results Serum thyroid stimulating hormone (TSH) and free thyroxine (T4) levels were significantly lower in the CPA group than in the HC and NFAIs groups (P < 0.001). The prevalence of central hypothyroidism was 12.8% in the CPA group and increased according to serum cortisol quartiles (P for trend = 0.025). According to the stepwise multiple linear regression analysis, serum cortisol was negatively associated with TSH and free T4 levels in the CPA group after adjustment for body mass index and age. Furthermore, decreased TSH levels were corrected by adrenalectomy [0.75 (0.50, 1.14) vs. 1.91 (1.36, 2.71) µIU/ml, P < 0.001], in parallel with a recovery in free T4 levels [11.20 (10.00, 12.43) vs. 12.04 (11.24, 13.01), P < 0.001]. Postoperative growth hormone and prolactin levels did not change compared with baseline.Conclusion Serum TSH and free T4 levels were decreased in patients with CPA, and dysfunction of the hypothalamic-pituitary-thyroid axis might be reversible after surgery.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Central hypothyroidism in patients with acromegaly and Cushing's disease occurs more often due to influence from hormonal overproduction or treatment rather than tumour compression.
“Central hypothyroidism in patients with acromegaly and Cushing's disease (Cai et al., 2020;Mathioudakis et al., 2012) occurs more often due to influence from the hormonal overproduction or the treatment (with e.g.somatostatin analogues) rather than tumour compression.”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Cai et al., 2020
Cites
Hollowell, J. G., Staehling, N. W., Flanders, W. D., Hannon, W. H., Gunter, E. W., Spencer, C. A., & Braverman, L. E. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.87.2.489 · Cited by 4,279 · see citing works
The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline.
Nieman, L. K., Biller, B. M. K., Findling, J. W., Newell-Price, J., Savage, M. O., Stewart, P. M., & Montori, V. M. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0125 · Cited by 2,718 · see citing works
Lacroix, A., Feelders, R. A., Stratakis, C. A., & Nieman, L. K. (2015) · The Lancet · doi:10.1016/s0140-6736(14)61375-1 · Cited by 1,777 · see citing works
Fassnacht, M., Arlt, W., Bancos, I., Dralle, H., Newell-Price, J., Sahdev, A., Tabarin, A., Terzolo, M., Tsagarakis, S., & Dekkers, O. M. (2016) · European Journal of Endocrinology · doi:10.1530/eje-16-0467 · Cited by 1,566 · see citing works
Fekete, C., & Lechan, R. M. (2014) · Endocrine Reviews · doi:10.1210/er.2013-1087 · Cited by 342 · see citing works
Beck‐Peccoz, P., Lania, A. G., Beckers, A. M., Chatterjee, K., & Wémeau, J.-L. (2013) · European Thyroid Journal · doi:10.1159/000351007 · Cited by 279 · see citing works
The role of glucocorticoids in the regulation of thyroid function in man
Nicoloff, J. T., Fisher, D. A., & Appleman, M. D. (1970) · Journal of Clinical Investigation · doi:10.1172/jci106411 · Cited by 261 · see citing works
Drugs that suppress TSH or cause central hypothyroidism
Haugen, B. R. (2009) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2009.08.003 · Cited by 252 · see citing works
Brabant, G. E., Brabant, A.-L., Ranft, U., OCRAN, K. W., Köhrle, J., Hesch, R. D., & Mühlen, A. V. Z. (1987) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-65-1-83 · Cited by 156 · see citing works
Regulation of in vivo TSH secretion by leptin
Seoane, L. M., Carro, E., Tovar, S., Casanueva, F. F., & Dieguez, C. (2000) · Regulatory Peptides · doi:10.1016/s0167-0115(00)00145-2 · Cited by 109 · see citing works
Alkemade, A., Unmehopa, U. A., Wiersinga, W. M., Swaab, D. F., & Fliers, E. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1430 · Cited by 101 · see citing works
Benker, G., Raida, M., Olbricht, T., Wagner, R., Reinhardt, W., & REINWEIN, D. (1990) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1990.tb03915.x · Cited by 94 · see citing works
Thyroid function and aging: gender-related differences
da Costa, V. C., Moreira, D., & Rosenthal, D. (2001) · Journal of Endocrinology · doi:10.1677/joe.0.1710193 · Cited by 93 · see citing works
Suppression of Cold-Stimulated Thyrotropin Secretion by Antiserum to Thyrotropin-Releasing Hormon
Szabó, M., & Frohman, L. A. (1977) · Endocrinology · doi:10.1210/endo-101-4-1023 · Cited by 75 · see citing works
Kobayashi (1980) · doi:10.1530/acta.0.1210095 · Cited by 75 · see citing works
Bartalena, L., Martino, E., PETRINI, L., Velluzzi, F., Loviselli, A., Grasso, L., Mammoli, C., & Pinchera, A. (1991) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-72-6-1195 · Cited by 59 · see citing works
Cintra, A., Fuxé, K., Wikstro¨m, A.-C., et al. (1990) · Brain Research · doi:10.1016/0006-8993(90)91210-8 · Cited by 57 · see citing works
Diminished and irregular TSH secretion with delayed acrophase in patients with Cushing's syndrome
Roelfsema, F., Pereira, A. M., Biermasz, N. R., Frölich, M., Keenan, D. M., Veldhuis, J. D., & Romijn, J. A. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0580 · Cited by 44 · see citing works
Lewis, B. M., Diéguez, C., Lewis, M. D., et al. (1987) · Journal of Endocrinology · doi:10.1677/joe.0.1150419 · Cited by 42 · see citing works
Taylor, A. D., Philip, J. G., John, C. D., Cover, P. O., Morris, J. F., Flower, R. J., & Buckingham, J. C. (2000) · Endocrinology · doi:10.1210/endo.141.6.7512 · Cited by 42 · see citing works
Regulation of TSH secretion and thyroid function in Cushing's disease
Visser, T., & Lamberts, S. W. J. (1981) · European Journal of Endocrinology · doi:10.1530/acta.0.0960480 · Cited by 41 · see citing works
Mathioudakis, N., Thapa, S., Wand, G. S., & Salvatori, R. (2012) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2012.04442.x · Cited by 30 · see citing works
Thyroid function in children with Cushing's disease before and after transsphenoidal surgery
Stratakis, C. A., Mastorakas, G., Magiakou, M.-A., Papavasiliou, E., Oldfield, E. H., & Chrousos, G. P. (1997) · The Journal of Pediatrics · doi:10.1016/s0022-3476(97)70041-6 · Cited by 22 · see citing works
Estupina, C., Belmar, J., Tapia‐Arancibia, L., ASTIER, H. S., & Arancibia, S. (1997) · Experimental Brain Research · doi:10.1007/bf02450331 · Cited by 20 · see citing works
A study of thyroid functions in patients with Cushing’s syndrome: a single-center experience
Xiang, B., Tao, R., Liu, X., Zhu, X., He, M., Ma, Z., Yang, Y., Zhang, Z., Li, Y., Yao, Z., et al. (2019) · Endocrine Connections · doi:10.1530/ec-19-0309 · Cited by 20 · see citing works
Effects of dexamethasone on the hypothalamic-pituitary-thyroid axis in rats
Mitsuma, T., & NOGIMORI, T. (1982) · European Journal of Endocrinology · doi:10.1530/acta.0.1000051 · Cited by 17 · see citing works
Dynamic changes of central thyroid functions in the management of Cushing's syndrome
Doğanşen, S. Ç., Yalın, G. Y., Canbaz, B., Tanrıkulu, S., & Yarman, S. (2018) · Archives of Endocrinology and Metabolism · doi:10.20945/2359-3997000000019 · Cited by 16 · see citing works
Clinical significance of fluctuations in thyroid hormones after surgery for Cushing’s syndrome
Tamada, D., Kitamura, T., Onodera, T., Hamasaki, T., Otsuki, M., & Shimomura, I. (2015) · Endocrine Journal · doi:10.1507/endocrj.ej15-0001 · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Feldt-Rasmussen, U., Effraimidis, G., & Klose, M. (2021) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2021.111173 · Cited by 170 · see citing works
- Authors
- Cai, R., Zhou, W., Jiang, L., Jiang, Y., Su, T., Zhang, C., Zhou, W., Ning, G., & Wang, W.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Corresponding author
- Wang, Weiqing
- ORCID
- Venue
- Endocrine
- Published
- 2020-04-14
- Volume
- 69
- Issue
- 1
- Pages
- 196-203
- ISSN
- 0969-711X (ISSN-L)
- 1355-008X
- 1559-0100
- OpenAlex
- W3015713101
- Cited by
- 18
- References
- 28
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 2 · 2021: 4
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81400779)
- Shanghai Municipal Commission of Health and Falimiy Planning (201840049)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Keywords
- cortisol-producing adenoma, hypercortisolism, thyroid function, central hypothyroidism, thyroid-stimulating hormone, free thyroxine, adrenalectomy, hypothalamic-pituitary-thyroid axis, pituitary function
- MeSH terms
- Adenoma, Adrenal Gland Neoplasms, Humans, Hydrocortisone, Retrospective Studies, Thyroid Gland, Thyrotropin
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review