The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index.
Long-Term Follow-Up in Adrenal Incidentalomas: An Italian Multicenter Study
Open accessAbstract
CONTEXT: The long-term consequences of subclinical hypercortisolism (SH) in patients with adrenal incidentalomas (AIs) are unknown. SETTING AND PATIENTS: In this retrospective multicentric study, 206 AI patients with a ≥5-year follow-up (median, 72.3 mo; range, 60-186 mo) were enrolled. INTERVENTION AND MAIN OUTCOME MEASURES: Adrenocortical function, adenoma size, metabolic changes, and incident cardiovascular events (CVEs) were assessed. We diagnosed SH in 11.6% of patients in the presence of cortisol after a 1 mg-dexamethasone suppression test >5 μg/dL (138 nmol/L) or at least two of the following: low ACTH, increased urinary free cortisol, and 1 mg-dexamethasone suppression test >3 μg/dL (83 nmol/L). RESULTS: At baseline, age and the prevalence of CVEs and type 2 diabetes mellitus were higher in patients with SH than in patients without SH (62.2 ± 11 y vs 58.5 ± 10 y; 20.5 vs 6%; and 33.3 vs 16.8%, respectively; P < .05). SH and type 2 diabetes mellitus were associated with prevalent CVEs (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1-9.0; and OR, 2.0; 95% CI, 1.2-3.3, respectively), regardless of age. At the end of the follow-up, SH was diagnosed in 15 patients who were without SH at baseline. An adenoma size >2.4 cm was associated with the risk of developing SH (sensitivity, 73.3%; specificity, 60.5%; P = .014). Weight, glycemic, lipidic, and blood pressure control worsened in 26, 25, 13, and 34% of patients, respectively. A new CVE occurred in 22 patients. SH was associated with the worsening of at least two metabolic parameters (OR, 3.32; 95% CI, 1.6-6.9) and with incident CVEs (OR, 2.7; 95% CI, 1.0-7.1), regardless of age and follow-up. CONCLUSION: SH is associated with the risk of incident CVEs. Besides the clinical follow-up, in patients with an AI >2.4 cm, a long-term biochemical follow-up is also required because of the risk of SH development.
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“A recent systematic review showed that ACS patients had a higher prevalence of cardiovascular events (16.7-26.8%) compared with patients with nonfunctional AI (6.7-10.4%) (79,244,245,247).”
From Adrenal incidentaloma (2020) · cites this paper as [244]
In the citing paper
“An Italian group reported an increased risk of ACS development if the adenoma size was >2.4 cm (sensitivity 73.3% and specificity 60.5%, P = .014) (244).”
From Adrenal incidentaloma (2020) · cites this paper as [244]
In the citing paper
“Focusing on glucose metabolism, the prevalence of IGT or DM has been higher in patients with SCS than in cases of nonfunctioning adenoma or controls (, , , , , , ), but these data were not confirmed by other studies that found much the same prevalence of these comorbidities in SCS as in the overall series of AI and in the general population (, -).”
From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [220]
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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
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
Haffner, S. M., Lehto, S., Rönnemaa, T., Pyörälä, K., & Laakso, M. (1998) · New England Journal of Medicine · doi:10.1056/nejm199807233390404 · Cited by 7,000
European guidelines on cardiovascular disease prevention in clinical practice: executive summary
Graham, I., Atar, D., Borch‐Johnsen, K., Boysen, G., Burell, G. K., Cífková, R., Dallongeville, J., Backer, G. D., Ebrahim, S. B. J., Gjelsvik, B., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehm316 · Cited by 3,865
Follow-up report on the diagnosis of diabetes mellitus
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus* (2003) · Diabetes Care · doi:10.2337/diacare.26.11.3160 · Cited by 3,784
The Incidentally Discovered Adrenal Mass
Young, W. F. (2007) · New England Journal of Medicine · doi:10.1056/nejmcp065470 · Cited by 1,090
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
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Perk, J., Backer, G. D., Gohlke, H., Graham, I. M., Reiner, Ž., Verschuren, W. M. M., Albus, C., Benlian, P., Boysen, G., Cífková, R., et al. (2012) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2012.05.007 · Cited by 702
Prevalence and natural history of adrenal incidentalomas
Barzon, L., Sonino, N., Fallo, F., Palu, G., & Boscaro, M. (2003) · European Journal of Endocrinology · doi:10.1530/eje.0.1490273 · Cited by 642
AME 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
Tauchmanovà, L., Rossi, R., Biondi, B., Pulcrano, M., Nuzzo, V., Palmieri, E.-A., Fazio, S., & Lombardi, G. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2001-011766 · Cited by 400
(2002) · PubMed · Cited by 326
Adrenal incidentaloma: a new cause of the metabolic syndrome?
Terzolo, M., Pia, A., Alì, A., Osella, G., Reimondo, G., Bovio, S., Daffara, F., Procopio, M., Paccotti, P., Borretta, G., et al. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.3.8277 · Cited by 322
Cawood, T. J., Hunt, P. J., O'Shea, D., Cole, D., & Soule, S. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0234 · Cited by 300
Diagnosis and Treatment of Subclinical Hypercortisolism
Chiodini, I. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2722 · Cited by 279 · cited 7×
“Even if SH has been associated with the risk of major cardiovascular events (CVEs) (32), large studies focused on “hard” end-points, such as major CVEs, are lacking (11).”
InfluentialRisk Factors and Long-Term Follow-Up of Adrenal Incidentalomas1
Barzon, L., Scaroni, C. M., Sonino, N., Fallo, F., Paoletta, A., & Boscaro, M. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.2.5444 · Cited by 255
Toniato, A., Merante-Boschin, I., Opocher, G., Pelizzo, M. R., Schiavi, F., & Ballotta, E. (2009) · Annals of Surgery · doi:10.1097/sla.0b013e31819a47d2 · Cited by 245 · cited 1×
“Some studies (22-26), but not all (27, 28), reported an improvement of the metabolic complications of SH (AH, weight, and glycemic control) and of the quality of life after adrenalectomy, while a worsening of these conditions in untreated patients.”
BackgroundLong-term follow-up study of patients with adrenal incidentalomas.
Libe, R., Dall'Asta, C., Barbetta, L., Baccarelli, A., Beck-Peccoz, P., & Ambrosi, B. (2002) · European Journal of Endocrinology · doi:10.1530/eje.0.1470489 · Cited by 215
Self-citationSubclinical Cushing's syndrome in adrenal incidentaloma.
Terzolo, Osella, Alì, Borretta, Cesario, Paccotti, & Angeli, A. (1998) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1998.00357.x · Cited by 198
Chiodini, I., Morelli, V., Salcuni, A. S., Eller-Vainicher, C., Torlontano, M., Coletti, F., Iorio, L., Cuttitta, A., Ambrosio, A., Vicentini, L., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2387 · Cited by 191
Self-citationUpdated review on the benefits of weight loss
Vidal, J. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0802215 · Cited by 188 · cited 2×
“a Body weight is considered improved or worsened in the presence of at least a 5% variation with respect to baseline (37).”
Dalmazi, G. D., Vicennati, V., Rinaldi, E., Morselli‐Labate, A. M., Giampalma, E., Mosconi, C., Pagotto, U., & Pasquali, R. (2012) · European Journal of Endocrinology · doi:10.1530/eje-11-1039 · Cited by 186
Development of overt Cushing’s syndrome in patients with adrenal incidentaloma
Barzon, L., Fallo, F., Sonino, N., & Boscaro, M. (2002) · European Journal of Endocrinology · doi:10.1530/eje.0.1460061 · Cited by 162
Morelli, V., Eller-Vainicher, C., Salcuni, A. S., Coletti, F., Iorio, L., Muscogiuri, G., Della Casa, S., Arosio, M., Ambrosi, B., Beck-Peccoz, P., et al. (2011) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.398 · Cited by 135
Subclinical Cushing’s syndrome: definition and management
Terzolo, M., Pia, A., & Reimondo, G. (2011) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2011.04253.x · Cited by 131
Adrenal incidentaloma—follow-up results from a Swedish prospective study.
Bülow, B., Jansson, S., Juhlin, C., Steen, L., Thorén, M., Wahrenberg, H., Valdemarsson, S., Wängberg, B., Ahréen, B., & _, _. (2006) · European Journal of Endocrinology · doi:10.1530/eje.1.02110 · Cited by 124
Arnaldi, G., & Boscaro, M. (2012) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2011.12.006 · Cited by 120
Hormonal activity of adrenal incidentalomas: results from a long-term follow-up study
Vassilatou, E., Vryonidou, A., Michalopoulou, S., Manolis, J., Caratzas, J., Phenekos, C., & Tzavara, I. (2009) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03492.x · Cited by 112
Morelli, V., Masserini, B., Salcuni, A. S., Eller‐Vainicher, C., Savoca, C., Viti, R., Coletti, F., Guglielmi, G., Battista, C., Iorio, L., et al. (2010) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2010.03794.x · Cited by 107
Erbil, Y., Ademoğlu, E., Özbey, N., Barbaros, U., Yanık, B. T., Salmaslıoğlu, A., Bozbora, A., & Özarmağan, S. (2006) · World Journal of Surgery · doi:10.1007/s00268-005-0681-x · Cited by 102
Iacobone, M., Citton, M., Viel, G., Boetto, R., Bonadio, I., Mondi, I., Tropea, S., Nitti, D., & Favia, G. (2012) · Surgery · doi:10.1016/j.surg.2012.08.054 · Cited by 101 · cited 1×
“Some studies (22-26), but not all (27, 28), reported an improvement of the metabolic complications of SH (AH, weight, and glycemic control) and of the quality of life after adrenalectomy, while a worsening of these conditions in untreated patients.”
BackgroundGiordano, R., Marinazzo, E., Berardelli, R., Picu, A., Maccario, M., Ghigo, E., & Arvat, E. (2010) · European Journal of Endocrinology · doi:10.1530/eje-09-0957 · Cited by 99
TSUIKI, M., TANABE, A., TAKAGI, S., NARUSE, M., & TAKANO, K. (2008) · Endocrine Journal · doi:10.1507/endocrj.k07e-177 · Cited by 97
Adrenal incidentaloma, clinical, metabolic, follow-up aspects: single centre experience
Comlekci, A., Yener, S., Ertilav, S., Secil, M., Akinci, B., Demir, T., Kebapcilar, L., Bayraktar, F., Yesil, S., & Eraslan, S. (2010) · Endocrine · doi:10.1007/s12020-009-9260-5 · Cited by 96
The prevalence of adrenal incidentaloma in routine clinical practice
Davenport, C., Liew, A., Doherty, B., Win, H. H. N., Misran, H., Hanna, S., Kealy, D., Al-Nooh, F., Agha, A., Thompson, C. J., et al. (2011) · Endocrine · doi:10.1007/s12020-011-9445-6 · Cited by 95
Bernini, G. P., Moretti, A., Oriandini, C., Bardini, M., Taurino, C., & Salvetti, A. (2005) · British Journal of Cancer · doi:10.1038/sj.bjc.6602459 · Cited by 87
Assessment of ACTH assay variability: a multicenter study
Pecori Giraldi, F., Saccani, A., Cavagnini, F., & _, _. (2011) · European Journal of Endocrinology · doi:10.1530/eje-10-0962 · Cited by 80
Fagour, C., Bardet, S., Rohmer, V., Arimone, Y., Lecomte, P., Valli, N., & Tabarin, A. (2008) · European Journal of Endocrinology · doi:10.1530/eje-08-0299 · Cited by 58
The natural history of incidentally discovered adrenocortical adenomas: a retrospective evaluation.
Grossrubatscher, E., Vignati, F., Possa, M., & Loli, P. (2001) · Journal of Endocrinological Investigation · doi:10.1007/bf03343941 · Cited by 52
Epicardial fat thickness and left ventricular mass in subjects with adrenal incidentaloma
Iacobellis, G., Petramala, L., Bárbaro, G., Kargi, A. Y., Serra, V., Zinnamosca, L., Colangelo, L., Marinelli, C., Ciardi, A., Toma, G. D., et al. (2013) · Endocrine · doi:10.1007/s12020-013-9902-5 · Cited by 40
Prospective evaluation of tumor size and hormonal status in adrenal incidentalomas
Yener, S., Ertilav, S., Seçil, M., Demir, T., Akıncı, B., Kebapçılar, L., Comlekci, A., Bayraktar, F., & Yeşil, S. (2009) · Journal of Endocrinological Investigation · doi:10.1007/bf03346546 · Cited by 40
Terzolo, M., Reimondo, G., & Angeli, A. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0473 · Cited by 18
Mauclère-Denost, S., Duron-Martinaud, S., Nunes, M. L., Gatta‐Cherifi, B., Fagour, C., Rault, A., Gosse, P., & Tabarin, A. (2009) · Annales d Endocrinologie · doi:10.1016/j.ando.2009.03.005 · Cited by 11
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Faßnacht, 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
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Debono, M., Bradburn, M., Bull, M., Harrison, B., Ross, R. J., & Newell-Price, J. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-3007 · Cited by 269
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Yip, L., Duh, Q., Wachtel, H., Jiménez, C., Sturgeon, C., Lee, C. Y., Velázquez‐Fernández, D., Berber, E., Hammer, G. D., Bancos, I., et al. (2022) · JAMA Surgery · doi:10.1001/jamasurg.2022.3544 · Cited by 273
Metadata
- Authors
- Morelli, V., Reimondo, G., Giordano, R., Della Casa, S., Policola, C., Palmieri, S., Salcuni, A. S., Dolci, A., Mendola, M., Arosio, M., Ambrosi, B., Scillitani, A., Ghigo, E., Beck-Peccoz, P., Terzolo, M., & Chiodini, I.
- Affiliations
- University of Milan (IT)
- Ospedale San Luigi Gonzaga (IT)
- University of Turin (IT)
- Catholic University (S.D.C., C.P.), Unit of Endocrinology and Metabolism, 00168 Rome, Italy
- Casa Sollievo della Sofferenza (IT)
- Department of Clinical Sciences and Community Health (V.M., S.P., A.D., M.A., P.B.-P., I.C.), University of Milan, 20122 Milan, Italy
- Corresponding author
- Morelli, Valentina
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-03-01
- Volume
- 99
- Issue
- 3
- Pages
- 827-834
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1990214209
- Cited by
- 223
- References
- 44
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 12 · 2023: 16 · 2022: 15 · 2021: 22 · 2020: 23 · 2019: 23 · 2018: 19 · 2017: 18 · 2016: 22 · 2015: 21 · 2014: 9
- FWCI
- 23.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Funders
- Regione Piemonte
- 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, adrenocortical function, cardiovascular events, type 2 diabetes, adenoma size, dexamethasone suppression test, metabolic control, long-term follow-up, ACTH, urinary free cortisol, hypertension, dyslipidemia, glycemic control, weight gain
- MeSH terms
- Adrenal Gland Neoplasms, Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Follow-Up Studies, Humans, Hydrocortisone, Italy, Male, Middle Aged, Retrospective Studies, Tumor Burden, Pituitary ACTH Hypersecretion
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