ArticleJournal of the Endocrine Society2020
Defining Nonfunctioning Adrenal Adenomas on the Basis of the Occurrence of Hypocortisolism after Adrenalectomy.
Article in Journal of the Endocrine Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 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
- Adrenalectomy Improves Blood Pressure and Metabolic Control in Patients With Possible Autonomous Cortisol Secretion: Results of a RCT.Frontiers in endocrinology · 2022Trial
- Adrenal incidentalomas: 1 mg dexamethasone test result in the context of cardiometabolic risk.Journal of endocrinological investigation · 2026Article
- Role of NP-59 SPECT/CT in the Management of Mild Autonomous Cortisol Secretion.Journal of clinical medicine · 2026Article
- The Relationship Between Bone Health Status of Post-Menopausal Women with Non-Functional Adrenal Tumours/Mild Autonomous Cortisol Secretion and Their Baseline Morning Adrenocorticotropic Level.Diagnostics (Basel, Switzerland) · 2026Article
- Lowering the dexamethasone suppression test cut-off: is it time yet?Journal of endocrinological investigation · 2025Review
- Review
- An Analysis of Post-Adrenalectomy Dynamics in MACS (Mild Autonomous Cortisol Secretion)-Positive Adrenal Tumours: The Biomarkers and Clinical Impact.Journal of clinical medicine · 2025Review
- Identification of Endogenous Hypercortisolism and the Effect of Mifepristone Treatment in Patients With Difficult-to-Manage Diabetes: A Case Series.Diabetes spectrum : a publication of the American Diabetes Association · 2025Article
- Fragility Fractures and Cortisol Secretion in Patients With Nonfunctioning Adrenal Incidentalomas.Journal of the Endocrine Society · 2024Article
- Diabetes Mellitus in Non-Functioning Adrenal Incidentalomas: Analysis of the Mild Autonomous Cortisol Secretion (MACS) Impact on Glucose Profile.Biomedicines · 2024Review
- Predicting postoperative hypocortisolism in patients with non-aldosterone-producing adrenocortical adenoma: a retrospective single-centre study.Journal of endocrinological investigation · 2024Article
- The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors.Cardiovascular diabetology · 2023Article
- Is the Adrenal Incidentaloma Functionally Active? An Approach-To-The-Patient-Based Review.Journal of clinical medicine · 2022Review
- Pathophysiology of Mild Hypercortisolism: From the Bench to the Bedside.International journal of molecular sciences · 2022Review
- Hidden hypercortisolism: a too frequently neglected clinical condition.Journal of endocrinological investigation · 2021Review
- Prevalence of less severe hypercortisolism in fractured patients admitted in an outpatient clinic for metabolic bone diseases.Endocrine · 2021Article
- Grand Challenge in Adrenal Endocrinology: Is the Legacy of the Past a Challenge for the Future of Precision Medicine?Frontiers in endocrinology · 2021Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with adrenal incidentalomas (AIs), there is uncertainty on how to rule out hypercortisolism. The occurrence of postsurgical (unilateral adrenalectomy) hypocortisolism (PSH) has been proposed as a proof of the presence of presurgical hypercortisolism in AI patients. The aim of this study was to define the thresholds of cortisol level after the 1 mg overnight dexamethasone suppression test (F-1mgDST), urinary free cortisol (UFC), midnight serum cortisol (MSC), and adrenocorticotropin (ACTH) to predict the absence of PSH in AI patients undergoing surgery.
methodsIn 60 patients who underwent AI excision, cortisol secretion was assessed by a low-dose corticotropin stimulation test or insulin tolerance test when needed. We searched for the lowest presurgical value of F-1mgDST, UFC, and MSC and the highest value for ACTH in AI patients with PSH as indexes of normal cortisol secretion.
resultsThe lowest values of F-1mgDST, UFC, and MSC and the highest value for ACTH in PSH patients were 1.2 µg/dL (33 nmol/L), 10.4 µg/24 hours (29 nmol/24 hours), 1.2 µg/dL (33 nmol/L), and 26.9 pg/mL (6 pmol/L), respectively, but only F-1mgDST <1.2 µg/dL (33 nmol/L) was able to predict the absence of PSH. Among AI patients with F-1mgDST <1.2 µg/dL (33 nmol/L) no subjects had diabetes mellitus and/or metabolic syndrome, and these subjects tended to have a better metabolic profile than those with F-1mgDST ≥1.2 µg/dL (33 nmol/L).
conclusionIn AI patients a F-1mgDST <1.2 µg/dL (33 nmol/L) rules out PSH and could be used to exclude hypercortisolism in AI patients.
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