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Cardiovascular Risk in Patients With Non-Functional Adrenal Incidentaloma: Myth or Reality?

20 Years
70 Years
Not Enrolling
Adrenal Cortex Neoplasms

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Trial Information

Cardiovascular Risk in Patients With Non-Functional Adrenal Incidentaloma: Myth or Reality?

None of the patients with AI showed specific signs and/or symptoms of hormone excess and
none were on hormonal therapy. All patients underwent the following endocrine workup aimed
to study the hypothalamic-pituitary-adrenal axis. Serum cortisol, and plasma corticotropin
(ACTH) were determined in basal conditions. All patients underwent an overnight 1-mg
dexamethasone test. The suppression was adequate when morning cortisol fell below 1.8 lg/dL
[21]. If inadequate, a two-day low-dose dexamethasone (DXM) suppression test was performed
(2 mg, four times a day for 2 days). Suppressibility was indicated when morning cortisol
fell below 1.8 g/dL after the last dose of dexamethasone. In all patients, urinary
metanephrine, and normetanephrine excretion were within normal limits and upright plasma
aldosterone to plasma renin activity ratio was lower than 20, excluding pheochromocytoma and
primary aldosteronism.

Metabolic syndrome criteria Metabolic syndrome criteria were determined according to the ATP
III and IDF 2005 guideline and modified as follows; (1) a waist circumference > 88 cm in
women and > 94 cm in men, (2) fasting glucose concentrations >100 mg/dl, (3) triglyceride
concentrations >150 mg/dl, (4) HDL cholesterol <40 mg/dl in men and <50 mg/dl in women, (5)
patients with hypertensive or on antihypertensive medication. Presence of waist criteria
plus at least two other criteria were accepted as sufficient for the presence of metabolic
syndrome. According to the IDF 2005 guideline, population-specific waist circumferences were
also used to evaluate abdominal obesity and metabolic syndrome. For this purpose, a waist
circumference of > 83 cm for women and > 95 cm for men were regarded as cut-offs for the
presence of abdominal obesity.

Cardiovascular Risk Parameters Cardiovascular Risk Parameters were as follows according to
ATP III; (1) family history of premature ischemic heart disease (ischemic heart disease in
male first-degree relatives < 55 years, in female first degree relatives < 65 years (2) for
male patients age > 45 years, for female patients age > 55 years or being in menopausal
state, (3) HDL cholesterol <40 mg/dl in men and <50 mg/dl in women (4) patients with
hypertensive or on antihypertensive medication, (5) patients regarded as diabetic (6)
current smokers.

Inclusion Criteria:

- Between September 2006 and September 2008, 35 patients (32 women and 3 men; mean age
49.1 ± 12 years) with adrenal incidentaloma (AI) were prospectively evaluated at the
Department of Endocrinology and General Surgery of Istanbul University, Istanbul
Medical Faculty.

Exclusion Criteria:

- Patients with known malignancies and clinical or subclinical hormone secreting tumors
were also excluded from this study. Patients with abnormalities of cortisol secretion
were also excluded.

Type of Study:


Study Design:

Time Perspective: Prospective

Outcome Measure:

Doppler ultrasonography

Outcome Time Frame:

at the time of the detection of the adrenal incidentaloma

Safety Issue:


Principal Investigator

yesim erbil, prof

Investigator Role:

Principal Investigator

Investigator Affiliation:

Istanbul University


Turkey: Ethics Committee

Study ID:




Start Date:

October 2007

Completion Date:

October 2008

Related Keywords:

  • Adrenal Cortex Neoplasms
  • adrenal incidentaloma
  • cardiovascular risk
  • Adrenal Cortex Neoplasms
  • Neoplasms
  • Adrenocortical Adenoma
  • Adrenal Gland Neoplasms