Evidence map›Paper›PMID 40966719›Full record

ArticleThe Journal of clinical endocrinology and metabolism2026

Cortisol Testing to Diagnose Adrenal Insufficiency Following Adrenalectomy for Mild Autonomous Cortisol Secretion.

Oksana Hamidi, Bahaa Salama, Tracy Wang, James W Findling, Catherine D Zhang, Ty Carroll, Sophie Dream, Alaa Sada, Vania Balderrama-Brondani, Prerna Dogra and 7 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Oksana HamidiDivision of Endocrinology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.ORCID 0000-0002-7367-3885
Bahaa SalamaDivision of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, MN 55905, USA.ORCID 0009-0004-5159-1127
Tracy WangDivision of Surgical Oncology, Section of Endocrine Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
James W FindlingDivision of Endocrinology and Molecular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA.ORCID 0000-0003-3101-5320
Catherine D ZhangDivision of Endocrinology and Molecular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Ty CarrollDivision of Endocrinology and Molecular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Sophie DreamDivision of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Alaa SadaDepartment of Surgery, Division of Endocrine Surgery, University of Pittsburgh, Pittsburgh, PA 15260, USA.
Vania Balderrama-BrondaniDepartment of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.ORCID 0000-0002-9327-9615
Prerna DograDepartment of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA.
Alan DackiwDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Sasan MirfakhraeeDivision of Endocrinology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.ORCID 0000-0002-4251-5737
Ankeeta MehtaDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Sarah OltmannDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Travis McKenzieDivision of Endocrine Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Trenton FosterDivision of Endocrine Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Irina BancosDivision of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, MN 55905, USA.ORCID 0000-0001-9332-2524

Funding

Skeletal Consequences of Mild Autonomous Cortisol SecretionK23DK121888 · NIDDK · MAYO CLINIC ROCHESTER · PI BANCOS, IRINA · 2019 to 2022
$630k
Exploring Pathophysiology and Treatment Approaches in Mild Autonomous Cortisol SecretionK23DK142038 · NIDDK · UT SOUTHWESTERN MEDICAL CENTER · PI Oksana Hamidi · 2025 to 2026
$379k
NIDDK NIH HHS 1K23DK142038-01A1NIDDK NIH HHS K23DK121888NIDDK NIH HHS K23 DK142038
6 · The paper itself

Abstract

contextPatients with mild autonomous cortisol secretion (MACS) can develop adrenal insufficiency after unilateral adrenalectomy.

objectiveThis work aimed to determine the prevalence, duration, and predictors of adrenal insufficiency, and compare postoperative basal cortisol and cosyntropin stimulation test (CST).

methodsIn this multicenter retrospective study of patients with MACS, adrenal insufficiency was diagnosed when postoperative basal cortisol was less than 10 µg/dL and/or CST < 18 µg/dL. The results were concordant when both tests met cutoffs. Biochemical (BSS) and clinical severity scores (CSS) were calculated.

resultsAmong 281 patients with MACS (80% women), postoperative adrenal insufficiency was diagnosed in 153 (54.5%) patients. Adrenal insufficiency inversely correlated with age (odds ratio [OR] 0.67 per 10 years; 95% CI, 0.53-0.84). Low basal cortisol and CST were associated with younger age (OR 0.64 per 10 years for both) and higher BSS (OR 1.17 and 1.22, respectively). Basal cortisol and CST were discordant in 22% of patients, and the discordance rate was more common in patients with bilateral nodules (32% vs 19%; P < .001). The median time to adrenal insufficiency recovery was 3.9 months (IQR, 3-5.9 months), with longer duration associated with higher BSS and CSS: 3 months for mild, 4 to 5 months for moderate, and 12 to 14 months for severe BSS and CSS.

conclusionApproximately half of patients with MACS developed postoperative adrenal insufficiency, with 50% recovering by 3.9 months after surgery. BSS correlated with basal cortisol, CST, and duration of adrenal insufficiency. As discordant results were noted in 22%, performing both basal cortisol and CST postoperatively should be considered.

Indexed as

AdrenalectomyAdrenal InsufficiencyHydrocortisonePostoperative ComplicationsAdultAgedCosyntropinFemaleHumansMaleMiddle AgedRetrospective StudiesCosyntropinHydrocortisoneadrenal adenomaadrenalectomyadrenal insufficiencybasal cortisolcosyntropin stimulation testhypercortisolism

Identifiers

PMID40966719
PMCPMC13056330

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Registered trials

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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.