Steroid profiling by LC-MS/MS in nonsecreting and subclinical cortisol-secreting adrenocortical adenomas
Abstract
CONTEXT: Long-term follow-up studies revealed that patients with subclinical hypercortisolism (SH) due to adrenocortical adenomas have an increased incidence of cardiovascular diseases and mortality. No studies have yet investigated the steroid profile and its implications in patients with SH. OBJECTIVE: The objective of the study was to analyze the steroid profile by liquid chromatography-tandem mass spectrometry in sera from patients with unilateral adrenocortical adenomas. DESIGN: This was a cross-sectional study. SETTING: The study was conducted at an outpatient clinic. PARTICIPANTS: Patients with adrenocortical adenomas (nonsecreting, n = 66; SH, n = 28) and 188 age- and sex-matched controls drawn from the general population participated in the study. MAIN OUTCOME MEASURES: Cortisol, 21-deoxycortisol, 11-deoxycortisol, 17-hydroxyprogesterone, androstenedione, dehydroepiandrosterone, T, progesterone, 11-deoxycorticosterone, and corticosterone in the basal condition and after a 1-24 ACTH test, and clinical data were measured. RESULTS: Patients with SH showed lower basal and 1-24 ACTH-stimulated levels of dehydroepiandrosterone and androstenedione than those with nonsecreting adenomas and controls. T was also lower in SH females. Receiver-operating characteristic curves showed that androgens had good accuracy in predicting SH (sensitivity and specificity were 71% and 76% for dehydroepiandrosterone and 69% and 61% for androstenedione, respectively). Increased cortisol and reduced dehydroepiandrosterone levels were independently associated with increased waist circumference. Cortisol was also independently associated with increased number of cardiovascular risk factors in SH patients. After 1-24 ACTH stimulation, the SH patients also showed increased production of 21-deoxycortisol and 11-deoxycorticosterone. CONCLUSIONS: Liquid chromatography-tandem mass spectrometry steroid profile performed for the first time in sera from patients with adrenocortical adenomas showed impaired secretion of several steroids in SH patients. This fingerprint can help in better characterizing the functional status of these tumors.
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Impaired glucose tolerance or diabetes has been reported to occur in 10% to 69% of patients with autonomous cortisol secretion.
“Impaired glucose tolerance or diabetes has been reported to occur in 10% to 69% of patients with ACS (249) and improved glycemic control (and in some cases reversal of diabetes) following surgery is reported in some studies but not others (Table 7).”
From Adrenal incidentaloma (2020) · cites this paper as [249]
Measurement of 11-deoxycortisol is not routinely used clinically, though recently serum results were reported in a cohort of benign adrenal tumors.
“Measurement of 11-deoxycortisol is not routinely used clinically, though recently serum results were reported in a cohort of benign adrenal tumors (249).”
From Adrenal incidentaloma (2020) · cites this paper as [249]
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- Authors
- Di Dalmazi, G., Fanelli, F., Mezzullo, M., Casadio, E., Rinaldi, E., Garelli, S., Giampalma, E., Mosconi, C., Golfieri, R., Vicennati, V., Pagotto, U., & Pasquali, R.
- Affiliations
- University of Bologna (IT)
- Corresponding author
- Pasquali, Renato
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2015-09
- Volume
- 100
- Issue
- 9
- Pages
- 3529-3538
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W878916761
- Cited by
- 82
- References
- 40
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 5 · 2023: 8 · 2022: 8 · 2021: 17 · 2020: 6 · 2019: 9 · 2018: 7 · 2017: 8 · 2016: 3
- FWCI
- 6.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (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
- subclinical hypercortisolism, adrenal adenoma, steroid profile, dehydroepiandrosterone, androstenedione, androgens, cortisol, ACTH stimulation test, 21-deoxycortisol, deoxycorticosterone, waist circumference, cardiovascular risk factors, sex differences, adrenal incidentaloma
- MeSH terms
- Adrenal Cortex Neoplasms, Aged, Androstenedione, Cortodoxone, Cosyntropin, Cross-Sectional Studies, Dehydroepiandrosterone, Female, Humans, Hydrocortisone, Male, Middle Aged, Adrenocortical Adenoma, 17-alpha-Hydroxyprogesterone, Tandem Mass Spectrometry
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