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]
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“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]
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“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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Follow-up report on the diagnosis of diabetes mellitus
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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
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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
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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
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
Sherlock, 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
“(79,244,245,247).”
Cortisol as a marker for increased mortality in patients with incidental adrenocortical adenomas
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
American Association of Endocrine Surgeons Guidelines for Adrenalectomy
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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