ArticleAnnals of internal medicine2016
"Nonfunctional" Adrenal Tumors and the Risk for Incident Diabetes and Cardiovascular Outcomes: A Cohort Study.
Article in Annals of internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03535532 (Effectiveness Comparison of Medical Treatment and Unilateral Laparoscopic Adrenalectomy for Resistant Hypertension in Patients Concomitant With Adrenal Diseases), which is not on this map. Cited by 88 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness Comparison of Medical Treatment and Unilateral Laparoscopic Adrenalectomy for Resistant Hypertension in Patients Concomitant With Adrenal Diseases: A Prospective, Multi-Center, Open-Labeled, Randomized Clinical Trial.
Who cites it
88 citing papers in PubMed, 3 syntheses or guidelines pooled it, 140 citations in OpenAlex.
- Metabolic complications and clinical outcomes of non-functioning adrenal incidentalomas: a systematic review and meta-analysis.BMC endocrine disorders · 2025Pooled 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
- Impact of overnight 1 mg dexamethasone on vascular function in patients with nonfunctioning adrenal adenomas.Scientific reports · 2023Trial
- Visualization of relative 11β-hydroxylase (CYP11B1) activity in human cortisol-producing adrenocortical adenoma (CPA) using mass spectrometry imaging-based enzyme histochemistry.Analytical and bioanalytical chemistry · 2026Article
- Mild autonomous cortisol secretion (MACS) is associated with increased mortality in patients with adrenal adenomas only in the presence of type 2 diabetes: a retrospective cohort study.Cardiovascular diabetology · 2026Article
- Adrenal incidentalomas: 1 mg dexamethasone test result in the context of cardiometabolic risk.Journal of endocrinological investigation · 2026Article
- Telomere length in patients with non-functional adrenal incidentalomas.Endocrine journal · 2026Article
- Hypercortisolism: Causes, Consequences and Clinical Significance - A Review of Pathophysiology.Diabetes, obesity & metabolism · 2026Review
- Recent progress in pathophysiology of cortisol-producing adrenal tumor.Endocrine journal · 2026Review
- Clinicopathological characteristics of adrenal tumors in older adults: a cohort study.Frontiers in endocrinology · 2026Article
- Adverse cardio-metabolic risk profile and epicardial adiposity in patients with adrenal adenoma: a cross-sectional study.Frontiers in endocrinology · 2026Article
- Artificial intelligence in endocrine practice: comparing ChatGPT, Gemini, and Claude for adrenal incidentaloma care.Journal of endocrinological investigation · 2026Article
- Lowering the dexamethasone suppression test cut-off: is it time yet?Journal of endocrinological investigation · 2025Review
- Increased arterial stiffness and atherosclerosis in patients with nonfunctioning adrenal incidentaloma.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Observational
- Estimation of cortisol exposure in patients with adrenal incidentalomas.BMC endocrine disorders · 2025Article
- Long-Term Persistence of Glycemic Dysregulation in Patients With a History of Pheochromocytoma/Paraganglioma.The Journal of clinical endocrinology and metabolism · 2025Article
- Prevalence and Incidence of Dementia in Patients With Non-Overtly Functional Adrenal Tumours.Clinical endocrinology · 2025Article
- Continuum of glucose and bone metabolism impairment across autonomous cortisol secretion: A cross-sectional study.World journal of diabetes · 2025Article
- Assessment of aortic perivascular and renal sinus fat in endogenous cortisol excess of different etiology.Hormones (Athens, Greece) · 2025Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundBenign adrenal tumors are commonly discovered on abdominal imaging. Most are classified as nonfunctional and are considered to pose no health risk, but some are considered functional because they secrete hormones that increase risk for metabolic and cardiovascular diseases.
objectiveTo evaluate the hypothesis that nonfunctional adrenal tumors (NFATs) increase risk for cardiometabolic outcomes compared with absence of adrenal tumors.
designCohort study.
settingIntegrated hospital system.
participantsParticipants with benign NFATs ("exposed"; n = 166) and those with no adrenal tumor ("unexposed"; n = 740), with at least 3 years of follow-up. MEASUREMENTS: Medical records were reviewed from the time of abdominal imaging for development of incident outcomes (hypertension, composite diabetes [prediabetes or type 2 diabetes], hyperlipidemia, cardiovascular events, and chronic kidney disease) (mean, 7.7 years). Primary analyses evaluated independent associations between exposure status and incident outcomes by using adjusted generalized linear models. Secondary analyses evaluated relationships between NFATs and cortisol physiology.
resultsParticipants with NFATs had significantly higher risk for incident composite diabetes than those without adrenal tumors (30 of 110 [27.3%] vs. 72 of 615 [11.7%] participants; absolute risk, 15.6% [95% CI, 6.9% to 24.3%]; adjusted risk ratio, 1.87 [CI, 1.17 to 2.98]). No significant associations between NFATs and other outcomes were observed. Higher "normal" postdexamethasone cortisol levels (≤50 nmol/L) were associated with larger NFAT size and higher prevalence of type 2 diabetes. LIMITATION: Potential bias in the selection of participants and ascertainment of outcomes.
conclusionParticipants with NFATs had a significantly higher risk for diabetes than those without adrenal tumors. These results should prompt a reassessment of whether the classification of benign adrenal tumors as "nonfunctional" adequately reflects the continuum of hormone secretion and metabolic risk they may harbor. PRIMARY FUNDING SOURCE: National Institutes of Health and Doris Duke Charitable Foundation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.