Cardiometabolic Disease Burden and Steroid Excretion in Benign Adrenal Tumors : A Cross-Sectional Multicenter Study.
Journal
Annals of internal medicine
ISSN: 1539-3704
Titre abrégé: Ann Intern Med
Pays: United States
ID NLM: 0372351
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
pubmed:
4
1
2022
medline:
15
4
2022
entrez:
3
1
2022
Statut:
ppublish
Résumé
Benign adrenal tumors are commonly discovered on cross-sectional imaging. Mild autonomous cortisol secretion (MACS) is regularly diagnosed, but its effect on cardiometabolic disease in affected persons is ill defined. To determine cardiometabolic disease burden and steroid excretion in persons with benign adrenal tumors with and without MACS. Cross-sectional study. 14 endocrine secondary and tertiary care centers (recruitment from 2011 to 2016). 1305 prospectively recruited persons with benign adrenal tumors. Cortisol excess was defined by clinical assessment and the 1-mg overnight dexamethasone-suppression test (serum cortisol: <50 nmol/L, nonfunctioning adrenal tumor [NFAT]; 50 to 138 nmol/L, possible MACS [MACS-1]; >138 nmol/L and absence of typical clinical Cushing syndrome [CS] features, definitive MACS [MACS-2]). Net steroid production was assessed by multisteroid profiling of 24-hour urine by tandem mass spectrometry. Of the 1305 participants, 49.7% had NFAT ( Cross-sectional design; possible selection bias. A cardiometabolic risk condition, MACS predominantly affects women and warrants regular assessment for hypertension and type 2 diabetes. Diabetes UK, the European Commission, U.K. Medical Research Council, the U.K. Academy of Medical Sciences, the Wellcome Trust, the U.K. National Institute for Health Research, the U.S. National Institutes of Health, the Claire Khan Trust Fund at University Hospitals Birmingham Charities, and the Mayo Clinic Foundation for Medical Education and Research.
Sections du résumé
BACKGROUND
BACKGROUND
Benign adrenal tumors are commonly discovered on cross-sectional imaging. Mild autonomous cortisol secretion (MACS) is regularly diagnosed, but its effect on cardiometabolic disease in affected persons is ill defined.
OBJECTIVE
OBJECTIVE
To determine cardiometabolic disease burden and steroid excretion in persons with benign adrenal tumors with and without MACS.
DESIGN
METHODS
Cross-sectional study.
SETTING
METHODS
14 endocrine secondary and tertiary care centers (recruitment from 2011 to 2016).
PARTICIPANTS
METHODS
1305 prospectively recruited persons with benign adrenal tumors.
MEASUREMENTS
METHODS
Cortisol excess was defined by clinical assessment and the 1-mg overnight dexamethasone-suppression test (serum cortisol: <50 nmol/L, nonfunctioning adrenal tumor [NFAT]; 50 to 138 nmol/L, possible MACS [MACS-1]; >138 nmol/L and absence of typical clinical Cushing syndrome [CS] features, definitive MACS [MACS-2]). Net steroid production was assessed by multisteroid profiling of 24-hour urine by tandem mass spectrometry.
RESULTS
RESULTS
Of the 1305 participants, 49.7% had NFAT (
LIMITATIONS
CONCLUSIONS
Cross-sectional design; possible selection bias.
CONCLUSION
CONCLUSIONS
A cardiometabolic risk condition, MACS predominantly affects women and warrants regular assessment for hypertension and type 2 diabetes.
PRIMARY FUNDING SOURCE
BACKGROUND
Diabetes UK, the European Commission, U.K. Medical Research Council, the U.K. Academy of Medical Sciences, the Wellcome Trust, the U.K. National Institute for Health Research, the U.S. National Institutes of Health, the Claire Khan Trust Fund at University Hospitals Birmingham Charities, and the Mayo Clinic Foundation for Medical Education and Research.
Substances chimiques
Hydrocortisone
WI4X0X7BPJ
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
325-334Subventions
Organisme : NIDDK NIH HHS
ID : K23 DK121888
Pays : United States
Organisme : Department of Health
Pays : United Kingdom
Organisme : Wellcome Trust
ID : WT101671
Pays : United Kingdom
Organisme : Wellcome Trust
ID : WT209492/Z/17/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0801473
Pays : United Kingdom
Investigateurs
Stephan Glöckner
(S)
Richard O Sinnott
(RO)
Anthony Stell
(A)
Maria Candida B V Fragoso
(MC)
Darko Kastelan
(D)
Ivana Dora Pupovac
(ID)
Bojana Simunov
(B)
Sarah Cazenave
(S)
Magalie Haissaguerre
(M)
Antoine Tabarin
(A)
Jérôme Bertherat
(J)
Rossella Libé
(R)
Tina Kienitz
(T)
Marcus Quinkler
(M)
Katharina Langton
(K)
Graeme Eisenhofer
(G)
Felix Beuschlein
(F)
Christina Brugger
(C)
Martin Reincke
(M)
Anna Riester
(A)
Ariadni Spyroglou
(A)
Stephanie Burger-Stritt
(S)
Timo Deutschbein
(T)
Martin Fassnacht
(M)
Stefanie Hahner
(S)
Matthias Kroiss
(M)
Sotiria Palimeri
(S)
Stylianos Tsagarakis
(S)
Ioanna Tsirou
(I)
Dimitra A Vassiliadi
(DA)
Vittoria Basile
(V)
Elisa Ingargiola
(E)
Giuseppe Reimondo
(G)
Massimo Terzolo
(M)
Letizia Canu
(L)
Massimo Mannelli
(M)
Hester Ettaieb
(H)
Harm R Haak
(HR)
Thomas M Kerkhofs
(TM)
Michael Biehl
(M)
Richard A Feelders
(RA)
Johannes Hofland
(J)
Leo J Hofland
(LJ)
Marianne A Grytaas
(MA)
Eystein S Husebye
(ES)
Grethe Å Ueland
(GÅ)
Urszula Ambroziak
(U)
Tomasz Bednarczuk
(T)
Agnieszka Kondracka
(A)
Magdalena Macech
(M)
Malgorzata Zawierucha
(M)
Isabel Paiva
(I)
M Conall Dennedy
(MC)
Ahmed Sajwani
(A)
Mark Sherlock
(M)
Rachel K Crowley
(RK)
Miomira Ivović
(M)
Ljiljana V Marina
(LV)
Jonathan J Deeks
(JJ)
Alice J Sitch
(AJ)
Lorna C Gilligan
(LC)
Beverly A Hughes
(BA)
Hannah E Ivison
(HE)
Carl Jenkinson
(C)
Donna M O'Neil
(DM)
Michael W O'Reilly
(MW)
Thomas G Papathomas
(TG)
Cristina L Ronchi
(CL)
Angela E Taylor
(AE)
Wiebke Arlt
(W)
Miriam Asia
(M)
Vasileios Chortis
(V)
Katharina Lang
(K)
Konstantinos N Manolopoulos
(KN)
Alessandro Prete
(A)
Robert P Sutcliffe
(RP)
Peter Guest
(P)
Kassiani Skordilis
(K)
Irina Bancos
(I)
Cristian Bancos
(C)
Alice Chang
(A)
Caroline J Davidge-Pitts
(CJ)
Danae A Delivanis
(DA)
Dana Erickson
(D)
Neena Natt
(N)
Todd B Nippoldt
(TB)
Melinda Thomas
(M)
William F Young
(WF)
Cedric H L Shackleton
(CHL)
Commentaires et corrections
Type : CommentIn