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Cited by 67Adrenal and Paraganglionic TumorsHormonal Regulation and HypertensionAdrenal Hormones and Disorders

Cardiovascular events in patients with mild autonomous cortisol secretion: analysis with artificial neural networks

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Morelli, Valentina, Palmieri, Serena, Lania, Andrea, Tresoldi, Alberto, Corbetta, Sabrina, Cairoli, Elisa, Eller-Vainicher, Cristina, Arosio, Maura +3 more·2017·European Journal of Endocrinology
DOI 10.1530/eje-17-0047
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Abstract

Background The independent role of mild autonomous cortisol secretion (ACS) in influencing the cardiovascular event (CVE) occurrence is a topic of interest. We investigated the role of mild ACS in the CVE occurrence in patients with adrenal incidentaloma (AI) by standard statistics and artificial neural networks (ANNs). Methods We analyzed a retrospective record of 518 AI patients. Data regarding cortisol levels after 1 mg dexamethasone suppression (1 mg DST) and the presence of obesity (OB), hypertension (AH), type-2 diabetes (T2DM), dyslipidemia (DL), familial CVE history, smoking habit and CVE were collected. Results The receiver-operating characteristic curve analysis suggested that 1 mg DST, at a cut-off of 1.8 µg/dL, had the best accuracy for detecting patients with increased CVE risk. In patients with 1 mg-DST ≥1.8 µg/dL (DST+, n = 223), age and prevalence of AH, T2DM, DL and CVE (66 years, 74.5, 25.9, 41.4 and 26.8% respectively) were higher than that of patients with 1 mg-DST ≤1.8 µg/dL (61.9 years, 60.7, 18.5, 32.9 and 10%, respectively, P < 0.05 for all). The CVE were associated with DST+ (OR: 2.46, 95% CI: 1.5–4.1, P = 0.01), regardless of T2DM, AH, DL, smoking habit, gender, observation period and age. The presence of at least two among AH, T2DM, DL and OB plus DST+ had 61.1% sensitivity in detecting patients with CVE. By using the variables selected by ANNs (familial CVE history, age, T2DM, AH, DL and DST+) 78.7% sensitivity was reached. Conclusions Cortisol after 1 mg-DST is independently associated with the CVE occurrence. The ANNs might help for assessing the CVE risk in AI patients.

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Authors
Morelli, V., Palmieri, S., Lania, A., Tresoldi, A., Corbetta, S., Cairoli, E., Eller-Vainicher, C., Arosio, M., Copetti, M., Grossi, E., & Chiodini, I.
Affiliations
  • University of Milan (IT)
  • Humanitas University (IT)
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
  • Casa Sollievo della Sofferenza (IT)
  • Semeion Centro Ricerche di Scienze della Comunicazione (IT)
Corresponding author
Chiodini, Iacopo
ORCID
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2017-07
Volume
177
Issue
1
Pages
73-83
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje-17-0047
OpenAlex
W2610976089
Cited by
67
References
39
Citations by year
2026: 4 · 2025: 2 · 2024: 5 · 2023: 8 · 2022: 9 · 2021: 13 · 2020: 14 · 2019: 4 · 2018: 6 · 2017: 2
FWCI
7.28
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • European Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
mild autonomous cortisol secretion, adrenal incidentaloma, cardiovascular events, dexamethasone suppression test, cortisol, cardiovascular risk prediction, artificial neural networks, hypertension, type 2 diabetes, dyslipidemia, obesity
MeSH terms
Adrenal Gland Neoplasms, Adult, Age Factors, Aged, Cardiovascular Diseases, Dexamethasone, Diabetes Mellitus, Type 2, Female, Humans, Hydrocortisone, Hypertension, Male, Middle Aged, Obesity, Retrospective Studies, Smoking, Prevalence, Neural Networks, Computer, Dyslipidemias

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