ArticleEndocrine2026
Post-dexamethasone cortisol levels in non-functioning adrenal incidentalomas: a pooled individual participant data analysis.
Article in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
introductionNon-functioning adrenal incidentalomas (NFAI) are defined by 1 mg-dexamethasone suppression test (F-1mgDST) cortisol levels < 1.8 µg/dL. However, many individuals with NFAI may exhibit subtle hypercortisolism associated with increased cardiometabolic and skeletal risk. The aims of the present study are to compare F-1mgDST distributions between individuals with NFAI and population-based controls and to explore whether alternative F-1mgDST thresholds would meaningfully modify patient classification.
methodsThis is a pooled individual participant data analysis of 7 studies evaluating cortisol secretion in patients with type 2 diabetes, osteoporosis and/or fragility fractures, hypertension, or adrenal incidentalomas. The study included 1681 participants (915 NFAI, 766 controls) with F-1mgDST < 1.8 µg/dL. Data included age, sex, body mass index (BMI), F-1mgDST, and adrenocorticotroph hormone (ACTH). We assessed the between-group differences in F-1mgDST and ACTH and the accuracy of different F-1mgDST thresholds for identifying NFAI.
resultsCompared to controls, patients with NFAI had lower age and ACTH levels (62.1 ± 9.8 and 59.8 ± 12.0 years, 25.1 ± 14.1 pg/mL and 16.3 ± 10.4, respectively, p < 0.001 for all comparisons), but higher BMI and F-1mgDST values (28.1 ± 4.9 and 29.0 ± 5.0 kg/m
conclusionsIndividuals with NFAI have higher F-1mgDST levels than controls. More than 40% overlap exists in F-1mgDST values between NFAI and controls.
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