The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index.
Beneficial Metabolic Effects of Prompt Surgical Treatment in Patients with an Adrenal Incidentaloma Causing Biochemical Hypercortisolism
Abstract
CONTEXT: In patients with adrenal incidentalomas, subclinical hypercortisolism (SH) is associated with an increased prevalence of the metabolic syndrome. The effect of surgical/conservative approach is debated. OBJECTIVE: The objective of the study was to determine the effect of the surgical and conservative approaches on the metabolic syndrome in patients with adrenal incidentalomas. DESIGN: This was a retrospective longitudinal study (18-48 months follow-up). SETTING: The study was conducted on an in- and outpatient basis. PATIENTS: One hundred eight patients with adrenal incidentalomas were studied for the presence of SH, which was diagnosed in the presence of more than two of the following: urinary free cortisol greater than 70 microg per 24 h (193 nmol per 24 h), cortisol after 1 mg dexamethasone suppression test greater than 3.0 microg/dl (83 nmol/liter), ACTH less than 10 pg/ml (2.2 pmol/liter). INTERVENTIONS: Surgery was performed in 25 patients with SH (group TrSH+) and 30 without SH (group TrSH-), whereas the conservative approach was chosen by 16 patients with SH (group UntrSH+) and 37 without SH (group UntrSH-). MAIN OUTCOME MEASURES: During the follow-up, the improvement/worsening of body weight, blood pressure, or glucose and cholesterol levels was defined in the presence of a greater than 5% weight decrease/increase and following the European Society of Cardiology or the Adult Treatment Panel III criteria, respectively. RESULTS: In group TrSH+, weight, blood pressure, and glucose levels improved (32, 56, and 48%, respectively) more frequently than in group UntrSH+ (12.5%, P = 0.05; 0.0%, P < 0.0001; 0.0%, P = 0.001; and 0.0%, P = 0.0014, respectively). In group UntrSH+, blood pressure, glucose, and low-density lipoprotein levels worsened more frequently (50.0, 37.5, and 50.0%, respectively) than in group TrSH+ (0.0%, P < 0.0001; 0.0%, P = 0.001; and 20.0%, P = 0.05, respectively). CONCLUSIONS: Regarding the various components of the metabolic syndrome, in patients with adrenal incidentalomas and SH, surgery is beneficial.
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
“Metabolic improvement after adrenalectomy, including weight loss, blood pressure lowering, glucose tolerance, lower lipids, and beneficial effects on bone have been reported (230,267).”
From Adrenal incidentaloma (2020) · cites this paper as [230]
In the citing paper
“Several studies have reported the outcome of surgical intervention but most involve small numbers and are retrospective, uncontrolled, and lack randomization (230,243,250-253,255) (Table 7).”
From Adrenal incidentaloma (2020) · cites this paper as [230]
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 [61]
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 [61]
In the citing paper
“On the contrary, in surgically untreated SH patients, blood pressure, glucose, and cholesterol levels worsened more frequently (50.0, 37.5, and 50.0%, respectively) than in surgically treated patients (0, 0, and 24%, respectively) (61).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [61]
In the citing paper
“In a retrospective, nonrandomized study, we reported that in 25 surgically treated SH patients, body weight, blood pressure, and glucose levels improved (32, 56, and 48%, respectively) more frequently than in untreated SH subjects (12.5, 0.0, and 0.0%, respectively) (61).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [61]
In the citing paper
“Similarly, because in some patients with SH not operated on, bone mineral density, fasting glucose, blood pressure, and cholesterol levels have been shown to worsen during follow-up (49, 61)”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [61]
In the citing paper
“the available data suggest a possible deleterious role of SH, at least on glucose and bone metabolism and on hypertension, even in patients adequately followed up with antihypertensive and antidiabetic medical therapy (61).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [61]
In the citing paper
“These uncertainties, in turn, bring into question the real clinical importance of SH itself and the need of a surgical treatment in these patients instead of the optimization of medical therapy (61).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [61]
Citations
Cites
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011
2013 ESH/ESC Guidelines for the management of arterial hypertension
Authors Task Force Members, Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cífková, R., Backer, G. D., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,739
Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus* (2002) · Diabetes Care · doi:10.2337/diacare.25.2007.s5 · Cited by 10,325
2007 Guidelines for the Management of Arterial Hypertension
Mancia, G., Backer, G. D., Dominiczak, A. F., Cífková, R., Fagard, R. H., Germanò, G., Grassi, G. M., Heagerty, A. M., Kjeldsen, S. E., Laurent, S., et al. (2007) · Journal of Hypertension · doi:10.1097/hjh.0b013e3281fc975a · Cited by 5,870
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
Management of the clinically inapparent adrenal mass ("incidentaloma")
Grumbach, M. M., Biller, B. M. K., Braunstein, G. D., Campbell, K. K., Carney, J. A., Godley, P. A., Harris, E. L., Lee, J. K. T., Oertel, Y. C., Posner, M. C., et al. (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-138-5-200303040-00013 · Cited by 945
A Survey on Adrenal Incidentaloma in Italy
Mantero, F. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.85.2.637 · Cited by 907
Prevalence of adrenal incidentaloma in a contemporary computerized tomography series
Bovio, S., Cataldi, A., Reimondo, G., Sperone, P., Novello, S., Berruti, A., Borasio, P., Fava, C., Dogliotti, L., Scagliotti, G. V., et al. (2006) · Journal of Endocrinological Investigation · doi:10.1007/bf03344099 · Cited by 712
Kratz (2004) · doi:10.1056/nejmcpc049016 · Cited by 593
Cited by
Sorted by citations
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
Treatment of Cushing's syndrome: an Endocrine Society clinical practice guideline
Nieman, L. K., Biller, B. M. K., Findling, J. W., Murad, M. H., Newell-Price, J., Savage, M. O., & Tabarin, A. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-1818 · Cited by 1,270
“However, retrospective studies suggest that patients with metabolic abnormalities are likely to benefit (29).”
BackgroundFaßnacht, M., Tsagarakis, S., Terzolo, M., Tabarin, A., Sahdev, A., Newell-Price, J. D. C., Pelsma, I. C. M., Marina, L., Lorenz, K., Bancos, I., et al. (2023) · European Journal of Endocrinology · doi:10.1093/ejendo/lvad066 · Cited by 849
“…on an association between MACS and either hypertension or hyperglycemia 12,29,39,40,103,108,110,112-114, 117, 118, 120, 123 , 101-104, 133 , 146, Assessment of bone mineral density by dual-energy X-ray absorptiometry has been shown to be a suboptimal tool to diagnose glucocorticoid-induced…”
BackgroundAME Position Statement on adrenal incidentaloma
Terzolo, M., Stigliano, A., Chiodini, I., Loli, P., Furlani, L., Arnaldi, G., Reimondo, G., Pia, A., Toscano, V., Zini, M., et al. (2011) · European Journal of Endocrinology · doi:10.1530/eje-10-1147 · Cited by 523
“Cushing‟s syndrome compared to patients treated conservatively (158).”
Self-citationSherlock, M., Scarsbrook, A., Abbas, A., Fraser, S., Limumpornpetch, P., Dineen, R., & Stewart, P. M. (2020) · Endocrine Reviews · doi:10.1210/endrev/bnaa008 · Cited by 347
“Metabolic improvement after adrenalectomy, including weight loss, blood pressure lowering, glucose tolerance, lower lipids, and beneficial effects on bone have been reported (230,267).”
Background
Metadata
- Authors
- Chiodini, I., Morelli, V., Salcuni, A. S., Eller-Vainicher, C., Torlontano, M., Coletti, F., Iorio, L., Cuttitta, A., Ambrosio, A., Vicentini, L., Pellegrini, F., Copetti, M., Beck-Peccoz, P., Arosio, M., Ambrosi, B., Trischitta, V., & Scillitani, A.
- Affiliations
- Department of Medical Sciences (I.C., V.M., A.S.S., C.E.-V., P.B.-P., M.A.), San Donato Institute, San Donato Milanese, 20122 Milan, Italy
- Casa Sollievo della Sofferenza (IT)
- Ospedale San Giuseppe (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- University of Milan (IT)
- Corresponding author
- Chiodini, Iacopo
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2010-06-01
- Volume
- 95
- Issue
- 6
- Pages
- 2736-2745
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2139061427
- Semantic Scholar
- def83fa11c628e121412927601cdf15281915ed5
- Cited by
- 191
- References
- 43
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 2 · 2023: 10 · 2022: 5 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 14 · 2017: 8 · 2016: 18 · 2015: 19 · 2014: 18 · 2013: 12 · 2012: 21
- FWCI
- 20.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- 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
- adrenal incidentaloma, subclinical hypercortisolism, metabolic syndrome, adrenalectomy, conservative treatment, body weight, blood pressure, glucose, cholesterol, urinary free cortisol, ACTH, dexamethasone suppression test
- MeSH terms
- Adrenal Gland Neoplasms, Adrenocorticotropic Hormone, Adult, Aged, Blood Glucose, Blood Pressure, Body Weight, Cholesterol, Cushing Syndrome, Dexamethasone, Female, Follow-Up Studies, Humans, Hydrocortisone, Cholesterol, LDL, Longitudinal Studies, Male, Middle Aged, Thyrotropin, Treatment Outcome, Metabolic Syndrome
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
