ArticleEndocrine connections2020
Diagnostic testing of autonomous cortisol secretion in adrenal incidentalomas.
Article in Endocrine connections, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 29 citations in OpenAlex.
- The Functional Side of Multiple Endocrine Neoplasia Type 1-Associated Adrenal Disease: Mild Autonomous Cortisol Secretion.Diseases (Basel, Switzerland) · 2026Article
- Coexisting mild autonomous cortisol secretion and isolated adrenocorticotropic hormone deficiency in a patient with an adrenal incidentaloma.JCEM case reports · 2026Article
- Plasma cortisol cut-off concentrations using the dexamethasone suppression test in patients with adrenal incidentalomas.Frontiers in endocrinology · 2026Observational
- Review
- Dehydroepiandrosterone Sulfate in Diagnosing Mild Autonomous Cortisol Secretion and Adrenal Insufficiency.Journal of the Endocrine Society · 2025Review
- Oxidative stress, antioxidant capacity, and cardiovascular risk in patients with non-functioning adrenal incidentalomas.Endocrine connections · 2025Article
- Who and how to screen for endogenous hypercortisolism in adrenal and pituitary incidentaloma.Journal of endocrinological investigation · 2025Review
- Diabetes Mellitus in Non-Functioning Adrenal Incidentalomas: Analysis of the Mild Autonomous Cortisol Secretion (MACS) Impact on Glucose Profile.Biomedicines · 2024Review
- Prevalence and Clinical Management of Adrenal Tumour-Related Hyperandrogenism: A Narrative Review.Life (Basel, Switzerland) · 2024Review
- The value of plasma metanephrine measurements during adrenal vein sampling.Endocrine connections · 2024Article
- An Overlooked Disease: Minimal Autonomous Cortisol Secretion (MACS). A Narrative Review.Endocrine, metabolic & immune disorders drug targets · 2024Review
- Choroidal Thickness in Mild Autonomous Cortisol Secretion.Sisli Etfal Hastanesi tip bulteni · 2024Article
- Influence of sex and functional status on the value of serum steroid profiling in discriminating adrenocortical carcinoma from adrenocortical adenoma.Frontiers in endocrinology · 2024Article
- Management of Adrenal Cortical Adenomas: Assessment of Bone Status in Patients with (Non-Functioning) Adrenal Incidentalomas.Journal of clinical medicine · 2023Review
- A machine learning approach to distinguishing between non-functioning and autonomous cortisol secreting adrenal incidentaloma on magnetic resonance imaging using texture analysis.Irish journal of medical science · 2023Article
- An update on adrenocortical cell lines of human origin.Endocrine · 2022Review
- Article
- The diagnostic value of salivary cortisol and salivary cortisone in patients with suspected hypercortisolism.Frontiers in endocrinology · 2022Article
- Approach to the Patient With Adrenal Incidentaloma.The Journal of clinical endocrinology and metabolism · 2021Review
- Diagnostic Accuracy of Dehydroepiandrosterone Sulfate and Corticotropin in Autonomous Cortisol Secretion.Biomedicines · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAutonomous cortisol secretion (ACS) is a condition with ACTH-independent cortisol overproduction from adrenal incidentalomas (AI) or adrenal hyperplasia. The hypercortisolism is often mild, and most patients lack typical clinical features of overt Cushing's syndrome (CS). ACS is not well defined and diagnostic tests lack validation.
methodsRetrospective study of 165 patients with AI evaluated clinically and by assay of morning plasma ACTH, late-night saliva cortisol, serum DHEA sulphate (DHEAS), 24-h urine-free cortisol, and cortisol after dexamethasone suppression.
resultsPatients with AI (n = 165) were diagnosed as non-functioning incidentalomas (NFI) (n = 82) or ACS (n = 83) according to current European guidelines. Late-night saliva cortisol discriminated poorly between NFI and ACS, showing a high rate of false-positive (23/63) and false-negative (38/69) results. The conventional low-dose dexamethasone suppression test (LDDST) did not improve the diagnostic specificity, compared with the 1 mg overnight DST. Receiver operating characteristic curve analysis of DHEAS in the two cohorts demonstrated an area under the curve of 0.76 (P < 0.01) with a sensitivity for ACS of 58% and a specificity of 80% using the recommended cutoff at 1.04 µmol/L (40 µg/dL).
conclusionWe here demonstrate in a large retrospective cohort of incidentaloma patients, that neither DHEAS, late-night saliva cortisol nor 24-h urine free cortisol are useful to discriminate between non-functioning adrenal incidentalomas and ACS. The conventional LDDST do not add further information compared with the 1 mg overnight DST. Alternative biomarkers are needed to improve the diagnostic workup of ACS.
Indexed as
Identifiers
What OpenQuestion holds
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.