Cortisol level after dexamethasone suppression test in patients with non-functioning adrenal incidentaloma is positively associated with the duration of reactive hyperemia response on microvascular bed

Paula, Marcela Pessoa de; Moraes, Aline Barbosa; Souza, Maria das Graças Coelho de; Cavalari, Emanuela; Campbell, Ruth; Fernandes, Giovanni; Farias, Maria Lúcia Fleiuss; Mendonça, L M C; Madeira, Miguel; Kraemer‐Aguiar, Luiz Guilherme; Neto, Leonardo Vieira

doi:10.1007/s40618-020-01360-z

Cited by 8 publications

(6 citation statements)

References 54 publications

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“…In another retrospective cross-sectional study, NFA and MACS were significantly more prevalent in patients with BMI ≥25 kg/m 2 across all age groups, compared to those with BMI < 25 kg/m 2 [23 ▪ ]. Although most data show the association between AI and higher BMI, in one recent study baseline BMI, as well as waist-to-hip circumference, fat and lean mass, and other parameters of body composition, did not differ between NFA and controls without adrenal tumors [27 ▪ ].…”

Section: Cardiovascular and Metabolic Consequences Of Asymptomatic Ad...mentioning

confidence: 79%

“…Although body composition was similar between the groups, patients with AI had larger waist circumference, higher waist-to-hip ratio, and increased prevalence of metabolic syndrome (using the WHO criteria) compared with controls (87.5%, 78.3%, and 43.6%, respectively) [39 ▪ ]. In contrast, one recent study found no difference between baseline BMI, waist-to-hip circumference, fat and lean mass and other parameters of body composition in patients with NFA and controls without adrenal tumors [27 ▪ ]. Nonetheless, most data support an association between AI and visceral fat accumulation in AI, which is an important, and potentially modifiable metabolic risk factor.…”

Section: Cardiovascular and Metabolic Consequences Of Asymptomatic Ad...mentioning

confidence: 84%

“…Similar findings were shown in another recent study of 154 patients with NFA, in which patients with NFA had significantly higher prevalence of HTN compared with age- and sex-matched controls without adrenal tumors (37% vs 20.1%, adjusted odds ratio (OR) of 2.26) [26 ▪ ]. In another recent study, patients with NFA required more antihypertensive drugs to achieve blood pressure control, which correlated with post-DST cortisol levels ( r = 0.29, P = 0.03), compared with age-, sex-, and body composition-matched controls (1.6 vs 1.0) [27 ▪ ]. Similar findings were reported in previous studies.…”

Section: Cardiovascular and Metabolic Consequences Of Asymptomatic Ad...mentioning

confidence: 98%

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Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas

Hamidi¹

2021

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review The incidence of adrenal tumors has increased over the past 20 years, most of which are incidentally discovered nonfunctioning adenomas (NFA) and tumors with mild autonomous cortisol secretion (MACS). This review aimed to summarize recent progress in understanding cardiometabolic risk in patients with NFA and MACS and to provide updates on the effect of treatment on improving outcomes in this population. Recent findings NFA and MACS are associated with adverse cardiovascular risk factors and metabolic derangements, which are likely mediated by excessive glucocorticoid secretion. Recent studies showed significantly higher prevalence of hypertension, impaired glucose metabolism, obesity, and dyslipidemia in patients with NFA and MACS. Adrenalectomy may improve comorbidities in selected patients. Summary Asymptomatic adrenal adenomas are common and are associated with adverse cardiometabolic changes. In selected patients, adrenalectomy may reduce cardiometabolic risk and improve clinical outcomes.

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Section: Cardiovascular and Metabolic Consequences Of Asymptomatic Ad...mentioning

confidence: 79%

Section: Cardiovascular and Metabolic Consequences Of Asymptomatic Ad...mentioning

confidence: 84%

Section: Cardiovascular and Metabolic Consequences Of Asymptomatic Ad...mentioning

confidence: 98%

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Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas

Hamidi¹

2021

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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“…In the last 2 years, new studies with a higher degree of evidence have emerged that support the association between NFAIs with an increased risk of hypertension, including resistant hypertension 13,19 and coronary artery/endothelial disease 35,52 . Tuna et al described a prevalence of hypertension of 39.3% in the NFAI group compared to 12.2% in controls ( p < .05) 53 .…”

Section: Resultsmentioning

confidence: 99%

Cardiometabolic profile and urinary metabolomic alterations in non‐functioning adrenal incidentalomas: A review

Araujo‐Castro

2022

Clinical Endocrinology

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Background: The incidence of adrenal incidentalomas (AIs) has increased over the last 20 years, most of which are apparently non-functioning adrenal adenomas. However, increased evidence supports the existence of an association between non-functioning adrenal incidentalomas (NFAI) and an unfavourable cardio-metabolic profile.Methods: This study offers a comprehensive review of the available evidence supporting a higher cardiometabolic risk in NFAIs compared to controls without adrenal tumours. Moreover, it summarises the studies focused on the differential urinary metabolomic profile of NFAI and controls without adrenal lesions.Results: This adverse metabolic profile of patients with NFAI includes a higher prevalence of insulin resistance, obesity, hypertension, hyperglycaemia, dyslipidaemia, and cardiovascular alterations and mortality compared to healthy controls without adrenal tumours. Although the pathophysiology that explains the association between NFAI and the parameters of metabolic syndrome and cardiovascular risk is a relatively unexplored field of study, some evidence supports that there are a series of incipient alterations in cortisol metabolism not detected with the classical tests that led to this detrimental profile. These alterations may be potentially detected by a comprehensive metabolomics approach. Several studies detected a shift towards an increase of urinary cortisol metabolites excretion in NFAIs compared to controls without adrenal tumours. Conclusion:In view of the higher cardiometabolic risk in NFAI than in controls without adrenal tumours, and the detected alterations in metabolomics profile of NFAI, I propose that the term of NFAI should be changed for another term that best fits to its linked cardiometabolic profile.

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“…For example, several studies suggest that the cutoff of cortisol after 1 mg overnight dexamethasone suppression test to diagnose hypercortisolism (i.e. 1.8 mg/dL) might not be sufficiently sensitive and that lower cut-offs might be adopted (33)(34)(35)(36). Paradoxically, some guidelines still advocate even higher cutoff points for diagnosing autonomous cortisol excess (37).…”

Section: What and How To Measurementioning

confidence: 99%

Grand Challenge in Adrenal Endocrinology: Is the Legacy of the Past a Challenge for the Future of Precision Medicine?

Chiodini

Gennari

2021

Front. Endocrinol.

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Cortisol level after dexamethasone suppression test in patients with non-functioning adrenal incidentaloma is positively associated with the duration of reactive hyperemia response on microvascular bed

Cited by 8 publications

References 54 publications

Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas

Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas

Cardiometabolic profile and urinary metabolomic alterations in non‐functioning adrenal incidentalomas: A review

Grand Challenge in Adrenal Endocrinology: Is the Legacy of the Past a Challenge for the Future of Precision Medicine?

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