The DOI matches its Crossref record; 25 of the 26 references it cites were found in a registry or an index.
The improvement of insulin resistance in patients with adrenal incidentaloma by surgical resection
Abstract
OBJECTIVE: Several recent studies have indicated that patients with adrenal incidentaloma often have disturbed glucose tolerance or/and hypertension. It is unclear whether these metabolic conditions could be caused by adrenal incidentaloma. We investigated the prevalence of disturbed glucose tolerance, hypertension and insulin resistance in the patients with non-functioning adrenal incidentaloma and evaluated the changes of the parameters such as glucose tolerance, blood pressure and insulin sensitivity after adrenalectomy. PATIENTS AND METHODS: Among 15 patients with incidentally discovered adrenal tumours in our department from 1996 to 1999, 4 patients were diagnosed as having pre-clinical Cushing's syndrome and the other 11 as having non-functioning tumours based on detailed endocrinological examinations including dexamethasone suppression testing. Four tumours with pre-clinical Cushing's syndrome and 8 tumours out of 11 patients with non-functioning tumours were diagnosed histopathologically as adrenocortical adenomas and the other 3 as of non-adrenal origin including a myelolipoma, an adrenal vascular cyst and an endothelioma. The prevalence of disturbed glucose tolerance was determined with an oral glucose tolerance test, and insulin sensitivity was evaluated by the method of steady state of plasma glucose (SSPG). RESULTS: All 12 patients with adrenocortical adenoma exhibited insulin resistance based on the SSPG (6.9-13.2 mmol/l). Before surgical removal of the tumours, the SSPG titre was relatively higher in the patients with pre-clinical Cushing's syndrome than in those with non-functioning with adrenocortical adenoma (mean value 11.65 vs. 8.99 mmol/l), whereas 2 of the 3 patients with non-adrenocortical tumours did not have insulin resistance. Among the 12 patients with adrenocortical adenoma, 7 (58%) and 9 (75%) patients exhibited hypertension and disturbed glucose tolerance, respectively. After removal of the tumours, SSPG of the patients with adrenocortical adenoma, but not that of the other 3 patients with non-cortical tumours, was significantly decreased compared to pre-adrenalectomy values. There are no significant differences in the changes of SSPG titres between in pre-clinical Cushing's syndrome and in non-functioning adrenocortical adenoma. Systolic blood pressure, but not diastolic blood pressure, was also significantly decreased in the patients with adrenocortical adenoma. CONCLUSION: High prevalences of disturbed glucose tolerance, insulin resistance and hypertension were found among the patients with non-functioning adrenocortical tumours. Adrenocortical adenoma may be one of the risk factors for insulin resistance that is believed to induce disturbed glucose tolerance and/or hypertension. Therefore, it is useful to evaluate insulin resistance for the patients with adrenal incidentalomas since results are likely to be helpful in deciding whether to remove the tumour by surgery.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
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?
In the citing paper
“In more than 25% of AI subjects, the lack of cortisol suppression after 1-or 3-mg overnight DST or 2-d low-dose DST (LDDST) (19,34,41,44,46,48,53,55,56,60,61)”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [46]
In the citing paper
“Several studies (19,21,32,34,38,39,44,46,49,53,60,61,67) and recently the French Society for Endocrinology (68), however, have proposed a lower cutoff to increase sensitivity.”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [46]
In the citing paper
“some authors have proposed higher (3 or 8 mg) dexamethasone doses (40,46,54,56), which however did not show a better performance (14,23,66).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [46]
In the citing paper
“To date, the 1-mg DST is the most used test to diagnose SH, either alone (34 -36, 38, 44 -46) or in combination with other parameters (9, 18, 21, 32, 37, 39, 42, 49, 52-54, 56, 60, 61).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [46]
In the citing paper
“The determination of ACTH levels after CRH does not seem to add any advantage (1,23,34,35,37,38,46) to screening for SH.”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [46]
In the citing paper
“Several small studies suggested the improvement of blood pressure (54, 93, 95), glucose metabolism (46,54,93,95), and body weight (54,95) in surgically treated SH patients.”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [46]
In the citing paper
“Few studies evaluated the accuracy of the SH diagnosis before surgery to predict the improvement after surgery and, therefore, to address the treatment of choice in the individual subject (18,46,61,93).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [46]
In the citing paper
“This is of utmost importance because in several studies some of the surgically treated patients without SH experienced improvement of some metabolic endpoints (18,46,61,93).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [46]
Citations
Cites
Role of Insulin Resistance in Human Disease
Reaven, G. M. (1988) · Diabetes · doi:10.2337/diab.37.12.1595 · Cited by 12,154
DeFronzo, R. A., & Ferrannini, E. (1991) · Diabetes Care · doi:10.2337/diacare.14.3.173 · Cited by 4,555
Recent Advances in Obesity Research
Bray, G. A. (1979) · Cited by 610
Reincke, M., Nieke, J., Krestin, G. P., Saeger, W., Allolio, B., & Winkelmann, W. (1992) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.75.3.1517373 · Cited by 346
Angeli, A., Osella, G., Ali, A., & Terzolo, M. (1997) · Hormone Research · doi:10.1159/000185477 · Cited by 259
Evaluation of octreotide to assess insulin-mediated glucose disposal by the insulin suppression test
Pei, D., Jones, C. N. O., Bhargava, R., Chen, Y. I., & Reaven, G. M. (1994) · Diabetologia · doi:10.1007/bf00404344 · Cited by 209
Endocrine evaluation of incidentally discovered adrenal masses (incidentalomas)
Osella, G., Terzolo, M., Borretta, G., Magro, G., Alí, A., Piovesan, A., Paccotti, P., & Angeli, A. (1994) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.79.6.7989452 · Cited by 206
Leibowitz, G., Tsur, A., Chayen, S. D., Salameh, M., Raz, I., Cerasi, E., & Gross, D. J. (1996) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1996.737558.x · Cited by 180
Adrenocortical Tumors: Recent Advances in Basic Concepts and Clinical Management
Bornstein, S. R., Stratakis, C. A., & Chrousos, G. P. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-130-9-199905040-00017 · Cited by 156
Adrenal incidentalomas: a manifestation of the metabolic syndrome?
Reincke, M., Faßnacht, M., Väth, S., Mora, P., & Allolio, B. (1996) · Endocrine Research · doi:10.1080/07435809609043773 · Cited by 133
Research works printed but not linked: 5
- Kuzuya T., 1997, Problem on the diagnostic criteria for diabetes mellitus, Japanese Journal of Clinical Medicine, 55, 247
- 10.1210/jc.79.6.1532 · DOI · Paper page
- 10.1210/jc.75.3.826 · DOI
- Tanaka K., 1997, CRH‐test, Japanese Journal of Clinical Medicine, 55, 341
- 10.1210/jc.81.2.740 · DOI
Cited by
Sorted by citations
Items 101–134 of 134
Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas
Hamidi, O. (2021) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000628 · Cited by 4
Does IGF-1 play a role in the etiopathogenesis of non-functioning adrenocortical adenoma?
Bahadır, Ç. T., Ecemiş, G. C., & Atmaca, H. N. (2018) · Journal of Endocrinological Investigation · doi:10.1007/s40618-018-0869-1 · Cited by 4
Tasaki, M., Kasahara, T., Takizawa, I., Saito, K., Nishiyama, T., & Tomita, Y. (2019) · International braz j urol · doi:10.1590/s1677-5538.ibju.2018.0235 · Cited by 4
Adrenal tumours and subclinical adrenal hyperfunction
Siemińśka, L., Siemińska, K., Marek, B., Kos‐Kudła, B., Nowak, M., Głogowska-Szeląg, J., & Kajdaniuk, D. (2024) · Endokrynologia Polska · doi:10.5603/ep.101940 · Cited by 3
Thompson, L. H., Nordenström, E., Almquist, M., & Bergenfelz, A. O. J. (2019) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-019-01844-4 · Cited by 3
Winzinger, E. P., Jandíková, H., Haase, M., Knauerhase, A., Winzinger, T., Schott, M., & Willenberg, H. S. (2021) · Hormone and Metabolic Research · doi:10.1055/a-1539-6442 · Cited by 3
Clinically Inapparent Adrenal Mass (Incidentaloma or Adrenaloma)
Linos, D. A. (2005) · Springer eBooks · doi:10.1007/3-540-26861-8_24 · Cited by 3
Akkuş, G., Aksoydan, Ü. P., Odabaş, F., Binokay, H., Sert, M., & Tetıker, T. (2025) · Current Medical Imaging Formerly Current Medical Imaging Reviews · doi:10.2174/0115734056347340241009102228 · Cited by 2
Guo, L., Lijie, Y., Wang, X., Bai, X., Tuoheti, K., Yisha, Z., Hu, D., & Liu, T. (2024) · World Journal of Urology · doi:10.1007/s00345-024-05134-7 · Cited by 2
Hormonal evaluation of adrenal incidentalomas
Loupp, A.-G. L., Cariou, B., Drui, D., Graveline, N., Masson, D., & Bach‐Ngohou, K. (2014) · Annales de biologie clinique · doi:10.1684/abc.2014.1013 · Cited by 2
Can non-functional adrenal incidentaloma be ranked among cardiovascular risk factors?
Yağız, B., Akalın, A., Yorulmaz, G., Macunluoğlu, A. C., & YAĞIZ, O. (2022) · The European Research Journal · doi:10.18621/eurj.872835 · Cited by 2
Kuznetsov, N. S., & Tihonova, O. V. (2015) · Endocrine Surgery · doi:10.14341/serg2015122-34 · Cited by 1
Functional and non-functional types of adrenal tumors: a case series
Indrawan, D. H., Prapiska, F. F., Warli, S. M., Sihombing, B., & Siregar, G. P. (2021) · F1000Research · doi:10.12688/f1000research.51593.1 · Cited by 1
Candemir, B., Kisip, K., Akın, Ş., Sanal, H. T., Taşar, M., Altunkaynak, B., & Gülçelik, N. E. (2024) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2024.111099 · Cited by 1
Siemińśka, L., Siemińska, K., Dittfeld, A., & Kotecka-Blicharz, A. (2024) · Endokrynologia Polska · doi:10.5603/ep.102598 · Cited by 1
Diagnostic Approach to Incidentaloma
Willenberg, H. S., & Bornstein, S. R. (2009) · Springer eBooks · doi:10.1007/978-0-387-77236-3_5 · Cited by 1
Relevance and perspective concept of investigation of subclinical Cushing syndrome.
Kuznetsov, N. S., Latkina, N. V., & Kaminarskaya, Y. A. (2016) · Endocrine Surgery · doi:10.14341/serg2016113-22 · Cited by 1
Síndrome de Cushing subclínico
Salvador, J., gÓmez, F., & Santos, E. (2004) · Endocrinología y Nutrición · doi:10.1016/s1575-0922(04)74618-5 · Cited by 1
Adrenal Incidentalomas and Arterial Hypertension
Παππά, Θ., Kaltsas, G., Piaditis, G. P., & Chrousos, G. P. (2012) · Humana Press eBooks · doi:10.1007/978-1-60761-548-4_6
New Perspectives on Diagnostics, Prognosis, and Therapy in Aggressive Endocrine Tumours
Appetecchia, M., Wolffenbuttel, B. H. R., & AlJadir, S. J. (2012) · Journal of Oncology · doi:10.1155/2012/820938
Insulin Resistance as a Disease of Civilization
Gierach, M., Spychalska, M., & Junik, R. (2013) · doi:10.12775/mbs-2013-0030
Sindrome di Cushing: forme atipiche
Corbetta, S., Ermetici, F., & Ambrosi, B. (2008) · L Endocrinologo · doi:10.1007/bf03344598
Bilateral adrenal tumors with subclinical hypercortisolemia. To operate or observe
Papierska, L., & Nowak, K. M. (2014) · Postępy Nauk Medycznych
L'incidentalome surrénalien, étude du statut métabolique et de la fibrinolyse
Thebert, J. (2015) · HAL
Cushing’s syndrome in obese patients with type 2 diabetes: A single center screening study
Karaman, Ö., Zuhur, S. S., Çil, E., Özderya, A., Öztürk, F. Y., İlhan, M., & Altuntaş, Y. (2016) · International Journal of Diabetes in Developing Countries · doi:10.1007/s13410-016-0494-5
2. Recent Progress on Clinical Management for Adrenal Disorders.
Nishikawa, T. (2012) · Nihon Naika Gakkai Zasshi · doi:10.2169/naika.101.605
Cardiovascular Risk Factors in Patients with Non-functional Adrenal Incidentalomas
Vardal, T. O. (2020) · Southern Clinics of Istanbul Eurasia · doi:10.14744/scie.2020.50455
Subclinical Cushing’s syndrome: lots of questions — little answers
Rybakov, S. I. (2021) · INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) · doi:10.22141/2224-0721.17.6.2021.243216
Insulin Resistance as a Disease of Civilization
Gierach, M., Spychalska, M., & Junik, R. (2013) · Medical and Biological Sciences · doi:10.2478/mbs-2013-0030
Emral, R., Aydoğan, B. İ., Köse, A. D., Demir, Ö., & Çorapçıoğlu, D. (2019) · Endocrinología Diabetes y Nutrición (English ed ) · doi:10.1016/j.endien.2019.08.005
Linos, D. A. (2009) · Springer eBooks · doi:10.1007/978-1-84628-881-4_31
Erdogan, H. B., Gül, K., Şahutoğlu, T., & Erdoğan, Ş. V. (2025) · Endocrine Connections · doi:10.1530/ec-25-0259
Metadata
- Authors
- Midorikawa, S., Sanada, H., Hashimoto, S., Suzuki, T., & Watanabe, T.
- Affiliations
- Fukushima Medical University (JP)
- Corresponding author
- Midorikawa, Sanae
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2001-06
- Volume
- 54
- Issue
- 6
- Pages
- 797-804
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2039932949
- Cited by
- 134
- References
- 26
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 7 · 2018: 7 · 2017: 1 · 2016: 5 · 2015: 7 · 2014: 6 · 2013: 7 · 2012: 10
- FWCI
- 3.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- 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 › Hormonal Regulation and Hypertension
- Keywords
- insulin resistance, adrenal incidentaloma, adrenalectomy, adrenal adenoma, glucose tolerance, hypertension, insulin sensitivity, steady-state plasma glucose, myelolipoma, endothelioma, adrenal myelolipoma
- MeSH terms
- Adenoma, Adrenal Cortex Neoplasms, Adrenalectomy, Adult, Aged, Blood Glucose, Child, Preschool, Cushing Syndrome, Female, Glucose Tolerance Test, Humans, Hypertension, Insulin Resistance, Male, Middle Aged
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
