ArticlePloS one2013
Adequately adapted insulin secretion and decreased hepatic insulin extraction cause elevated insulin concentrations in insulin resistant non-diabetic adrenal incidentaloma patients.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Cardiometabolic Risk Parameters in "Nonfunctioning" Adrenal Incidentalomas: A Systematic Review and Meta-analysis.The Journal of clinical endocrinology and metabolism · 2026Pooled it
- Cardiometabolic comorbidities and cardiovascular events in "non-functioning" adrenal incidentalomas: a systematic review and meta-analysis.Journal of endocrinological investigation · 2024Pooled it
- Nonfunctional adrenal adenomas and impaired glucose metabolism: a systematic review and meta-analysis.Endocrine · 2021Pooled it
- Adverse cardio-metabolic risk profile and epicardial adiposity in patients with adrenal adenoma: a cross-sectional study.Frontiers in endocrinology · 2026Article
- Lowering the dexamethasone suppression test cut-off: is it time yet?Journal of endocrinological investigation · 2025Review
- Metabolic phenotype in non-aldosterone producing adrenal adenomas with co-existent polycystic ovary syndrome: a joint Ens@t project.Endocrine · 2025Article
- Glucose Alterations, Insulin Resistance, Arterial Hypertension, and Renin are Strictly Associated in Pediatric Obesity.Journal of the Endocrine Society · 2023Article
- Impairment in insulin secretion without changes in insulin resistance explains hyperglycemia in patients with acromegaly treated with pasireotide LAR.Endocrine connections · 2022Article
- C-Peptide-based assessment of insulin secretion in the Zucker Fatty rat: a modelistic study.PloS one · 2015Article
- Whole-body insulin sensitivity rather than body-mass-index determines fasting and post-glucose-load growth hormone concentrations.PloS one · 2014Article
- Insulin-like growth factor 1 predicts post-load hypoglycemia following bariatric surgery: a prospective cohort study.PloS one · 2014Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInsulin-resistance is commonly found in adrenal incidentaloma (AI) patients. However, little is known about beta-cell secretion in AI, because comparisons are difficult, since beta-cell-function varies with altered insulin-sensitivity.
objectivesTo retrospectively analyze beta-cell function in non-diabetic AI, compared to healthy controls (CON).
methodsAI (n=217, 34%males, 57 ± 1 years, body-mass-index:27.7 ± 0.3 kg/m(2)) and CON [n = 25, 32%males, 56 ± 1 years, 26.7 ± 0.8 kg/m(2)] with comparable anthropometry (p ≥ 0.31) underwent oral-glucose-tolerance-tests (OGTTs) with glucose, insulin, and C-peptide measurements. 1mg-dexamethasone-suppression-tests were performed in AI. AI were divided according to post-dexamethasone-suppression-test cortisol-thresholds of 1.8 and 5 µg/dL into 3 subgroups: pDexa<1.8 µg/dL, pDexa1.8-5 µg/dL and pDexa>5 µg/dL. Using mathematical modeling, whole-body insulin-sensitivity [Clamp-like-Index (CLIX)], insulinogenic Index, Disposition Index, Adaptation Index, and hepatic insulin extraction were calculated.
resultsCLIX was lower in AI combined (4.9 ± 0.2 mg · kg(-1) · min(-1)), pDexa<1.8 µg/dL (4.9 ± 0.3) and pDexa1.8-5 µg/dL (4.7 ± 0.3, p<0.04 vs.CON:6.7 ± 0.4). Insulinogenic and Disposition Indexes were 35%-97% higher in AI and each subgroup (p<0.008 vs.CON), whereas C-peptide-derived Adaptation Index, compensating for insulin-resistance, was comparable between AI, subgroups, and CON. Mathematical estimation of insulin-derived (insulinogenic and Disposition) Indexes from associations to insulin-sensitivity in CON revealed that AI-subgroups had ~19%-32% higher insulin-secretion than expectable. These insulin-secretion-index differences negatively (r=-0.45, p<0.001) correlated with hepatic insulin extraction, which was 13-16% lower in AI and subgroups (p<0.003 vs.CON).
conclusionsAI-patients show insulin-resistance, but adequately adapted insulin secretion with higher insulin concentrations during an OGTT, because of decreased hepatic insulin extraction; this finding affects all AI-patients, regardless of dexamethasone-suppression-test outcome.
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