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Cited by 52Adrenal and Paraganglionic TumorsAdrenal Hormones and DisordersPancreatic function and diabetes

The size of adrenal incidentalomas correlates with insulin resistance. Is there a cause-effect relationship?: The size of AI correlates with insulin resistance

Muscogiuri, Giovanna, Sorice, Gian Pio, Prioletta, Annamaria, Mezza, Teresa, Cipolla, Clelia, Salomone, Enrica, Giaccari, Andrea, Pontecorvi, Alfredo +1 more·2011·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2010.03928.x
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Abstract

CONTEXT: Adrenal incidentalomas (AI) have often been associated with a high prevalence of insulin resistance (IR) and cardiovascular risk factors, although direct measurement of insulin sensitivity (IS) has never been carried out. OBJECTIVE: We aimed to investigate whether the morphological and hormonal features of AI correlate with the presence and severity of IR, using the hyperinsulinaemic euglycaemic clamp (HEC). DESIGN AND MEASUREMENTS: Forty patients with AI (22 women) with a mean age of 58.5±11.1 years underwent hormonal and morphological evaluation. Nineteen patients with AI without known history of diabetes mellitus (DM) or impaired glucose tolerance (IGT) and 17 matched controls underwent oral glucose tolerance test (OGTT) and hyperinsulinaemic euglycaemic clamp (HEC). RESULTS: Diabetes mellitus was observed in 13 patients (33%), while three (8%) had IGT. Thirty-one of the AI were nonfunctioning (82.5%), whereas two (5%) secreted cortisol (Cushing's syndrome) and seven (12.5%) showed subclinical secretion of cortisol. The 19 patients with nonfunctioning AI were more insulin resistant than controls (glucose up-take: 4.58±1.80 vs 5.85±2.48 mg/kg/min respectively; P=0.01); IS was inversely related to the mass size (r=-0.57; P=0.04), free urinary cortisol (r=-0.68; P=0.01), serum cortisol after 1-mg dexamethasone suppression (-0.65; P=0.02) and percentage of trunk fat mass (-0.77; P=0.02) and directly related to serum adreno cortico tropic hormone (ACTH) (r=0.62; P=0.03). After performing multivariate regression, the mass size was found to be the most powerful predictor of IR. CONCLUSION: Our study showed a high prevalence of insulin resistance in patients with nonfunctioning AI and suggests its possible involvement in AI growth.

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Crossref · 10.1111/j.1365-2265.2010.03928.x

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  • Overall, diabetes or impaired glucose tolerance was identified in 20% to 25% of patients with adrenal incidentaloma and subclinical Cushing syndrome and was related to age, adenoma size, midnight cortisol level, and plasma cortisol after dexamethasone suppression.

    “Overall, DM or IGT was identified in % to % of patients with AI and SCS and was related to patients' age (), the size of their adenomas, their midnight cortisol level, and their plasma cortisol level after suppression with dexamethasone ().”

    From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [219]

  • Insulin is mitogenic, capable of stimulating adrenal cortex cell proliferation and tumor formation in a time- and dose-dependent manner without affecting cortisol synthesis.

    “In fact, it has been demonstrated that insulin is mitogenic, capable of stimulating adrenal cortex cell proliferation and tumor formation in a time-and dose-dependent manner, without affecting cortisol synthesis (, ).”

    From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [219]

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Authors
Muscogiuri, G., Sorice, G. P., Prioletta, A., Mezza, T., Cipolla, C., Salomone, E., Giaccari, A., Pontecorvi, A., & Della Casa, S.
Affiliations
Università Cattolica del Sacro Cuore (IT)
Corresponding author
Muscogiuri, Giovanna
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2011-02-08
Volume
74
Issue
3
Pages
300-305
ISSN
0300-0664 (ISSN-L)
DOI
10.1111/j.1365-2265.2010.03928.x
OpenAlex
W2167088218
Cited by
52
References
35
Citations by year
2026: 2 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 4 · 2018: 6 · 2017: 4 · 2016: 2 · 2015: 4 · 2014: 1 · 2013: 1 · 2012: 1
FWCI
2.02
Type
journal article
Language
en
Open access
closed
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 1666 d)
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 › Surgery › Pancreatic function and diabetes
Keywords
adrenal incidentaloma, insulin resistance, tumor size, hyperinsulinemic-euglycemic clamp, insulin sensitivity, ACTH, dexamethasone suppression, trunk fat mass, Cushing's syndrome, non-functioning adrenal tumor, impaired glucose tolerance, diabetes mellitus
MeSH terms
Adrenal Gland Neoplasms, Aged, Diabetes Mellitus, Female, Glucose Tolerance Test, Humans, Hydrocortisone, Insulin Resistance, Male, Middle Aged, Regression Analysis, Glucose Clamp Technique, Multivariate Analysis

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