Number of comorbidities predicts adrenal incidentaloma and autonomic cortisol secretion in obese individuals: A two-center cohort study
Endocrine, cilt.90, sa.2, ss.982-994, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 90 Sayı: 2
- Basım Tarihi: 2025
- Doi Numarası: 10.1007/s12020-025-04355-z
- Dergi Adı: Endocrine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, EMBASE, MEDLINE
- Sayfa Sayıları: ss.982-994
- Anahtar Kelimeler: Obesity, Adrenal incidentaloma, Dexamethasone suppression test, Hypertension, Type 2 diabetes mellitus, Autonomic cortisol hypersecretion
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: The objective of this study was to investigate the association between number of comorbidities (NOC) with adrenal incidentaloma (AI) and autonomic cortisol hypersecretion (ACS) in obese individuals. Methods: This cohort study included 855 obese individuals (males/females: 175/680), who presented with obesity and were screened with 1 mg dexamethasone suppression test (DST). Hypertension (HT); type 2 diabetes mellitus (T2DM); hyperlipidaemia (HL); coronary artery disease (CAD); frequency of AI (in 255 patients with imaging) data were obtained from patient files. Patients were categorized according to DST cortisol levels as <0.9 μg/dL (group 1 [G1]), 0.9–1.8 μg/dL (G2) and >1.8 μg/dL (G3, defined as ACS). Results: Frequency of ACS and AI according to NOC; NOC-0 (0.5%, 2.5%), NOC-1 (0.9%, 15.8%), NOC-2 (3.4%, 23.5%), NOC-3 (4.1%, 15.1%), NOC-4 (13.6%, 35.7%). Increased frequency of ACS and AI in NOC-2, NOC-3, NOC-4 vs. NOC-0 group (P < 0.05 for all). The prevalence of T2DM, HT, HL CAD and AI was lower in the group with a G1 (18.5%, 19.5%, 31.7%, 3.6%, 3%) compared to those in the G2 (43.8%, 70.5%, 52.7%, 12.5%, 52.4%, P < 0.001 for all) and G3 (42.9%, 78.6%, 78.6%, 21.4%, 61.5%, P < 0.001 for all), frequency of comorbidities and AI in G2 vs. G3 are similar. DST result was found to be an independent factor the presence of any comorbidity. Conclusion: In obese individuals, NOC-2 and higher levels are associated with an increased incidence of AI and ACS. DST is a simple and reliable test to demonstrate this association, and a cut-off of 0.9 μg/dL may be more sensitive.