Download PDF
Horm Metab Res 2018; 50(07): 551-555
DOI: 10.1055/a-0630-1397
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Could Lipid Profile be Used as a Marker of Autonomous Cortisol Secretion in Patients with Adrenal Incidentalomas?

Gesthimani Mintziori
1   Department of Endocrinology, Diabetes and Metabolism, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
,
Thomas Georgiou
1   Department of Endocrinology, Diabetes and Metabolism, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
,
Panagiotis Anagnostis
1   Department of Endocrinology, Diabetes and Metabolism, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
,
Fotini Adamidou
1   Department of Endocrinology, Diabetes and Metabolism, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
,
Zoe Efstathiadou
1   Department of Endocrinology, Diabetes and Metabolism, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
,
Athanasios Panagiotou
1   Department of Endocrinology, Diabetes and Metabolism, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
,
Marina Kita
1   Department of Endocrinology, Diabetes and Metabolism, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
› Author Affiliations
Further Information

Publication History

received 10 March 2018

accepted 08 May 2018

Publication Date:
10 July 2018 (online)

Also available at
    Permissions and Reprints

Abstract

Adrenal incidentalomas (AIs) have been associated with an increased risk of metabolic syndrome and dyslipidemia, though evidence regarding the latter is limited. Lipid abnormalities in patients with AIs have been associated with subclinical hypercortisolism. The current study aims to test whether lipid profile in patients with AIs predicts “autonomous cortisol secretion” (ACS). Patients with AIs found on either computerized tomography (CT) or magnetic resonance imaging (MRI), were included in a prospective cohort study. All patients were followed up for at least three years. Alterations in their hormonal and lipid profiles were recorded. Ninety-four patients (69 women) harboring 111 AIs were included. There were no differences between patients with ACS and those without, with respect to their baseline lipid profile [total cholesterol, low-density-lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C) and non-HDL-C] and blood pressure (systolic and diastolic). Non-HDL-C concentrations decreased over time (Repeated Measures ANOVA, p=0.013), despite patients’ body mass index (BMI) remaining unchanged. Logistic regression analysis revealed that the only predictor of ACS was the size of AIs, as calculated by CT or MRI. The current study demonstrated that lipid profile at baseline or during follow-up cannot predict ACS in patients with AIs. However, larger AIs may have a greater probability of ACS.

Key words

adrenal incidentalomas - autonomous cortisol secretion - subclinical Cushing - dyslipidemia
 

  • References

  • 1 Anagnostis P, Karagiannis A, Tziomalos K, Kakafika AI, Athyros VG, Mikhailidis DP. Adrenal incidentaloma: A diagnostic challenge. Hormones 2009; 8: 163-184
    CrossrefPubMedSearch in Google Scholar
  • 2 Anagnostis P, Efstathiadou Z, Polyzos SA, Tsolakidou K, Litsas ID, Panagiotou A, Kita M. Long term follow-up of patients with adrenal incidentalomas – a single center experience and review of the literature. Exp Clin Endocrinol Diabetes 2010; 118: 610-616
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Di Dalmazi G, Pasquali R, Beuschlein F, Reincke M. Subclinical hypercortisolism: A state, a syndrome, or a disease?. Eur J Endocrinol 2015; 173: M61-M71
    CrossrefPubMedSearch in Google Scholar
  • 4 Androulakis II, Kaltsas GA, Kollias GE, Markou AC, Gouli AK, Thomas DA, Alexandraki KI, Papamichael CM, Hadjidakis DJ, Piaditis GP. Patients with apparently nonfunctioning adrenal incidentalomas may be at increased cardiovascular risk due to excessive cortisol secretion. J Clin Endocrinol Metab 2014; 99: 2754-2762
    CrossrefPubMedSearch in Google Scholar
  • 5 Perogamvros I, Vassiliadi DA, Karapanou O, Botoula E, Tzanela M, Tsagarakis S. Biochemical and clinical benefits of unilateral adrenalectomy in patients with subclinical hypercortisolism and bilateral adrenal incidentalomas. Eur J Endocrinol 2015; 173: 719-725
    CrossrefPubMedSearch in Google Scholar
  • 6 Muscogiuri G, Colao A, Orio F. Insulin-mediated diseases: Adrenal mass and polycystic ovary syndrome. Trends Endocrinol Metab 2015; 26: 512-514
    CrossrefPubMedSearch in Google Scholar
  • 7 Peppa M, Boutati E, Koliaki C, Papaefstathiou N, Garoflos E, Economopoulos T, Hadjidakis D, Raptis SA. Insulin resistance and metabolic syndrome in patients with nonfunctioning adrenal incidentalomas: A cause-effect relationship?. Metabolism Clin Exp 2010; 59: 1435-1441
    CrossrefPubMedSearch in Google Scholar
  • 8 Muscogiuri G, Sorice GP, Prioletta A, Mezza T, Cipolla C, Salomone E, Giaccari A, Pontecorvi A, Della Casa S. The size of adrenal incidentalomas correlates with insulin resistance. Is there a cause-effect relationship?. Clin Endocrinol 2011; 74: 300-305
    CrossrefPubMedSearch in Google Scholar
  • 9 Di Dalmazi G, Vicennati V, Garelli S, Casadio E, Rinaldi E, Giampalma E, Mosconi C, Golfieri R, Paccapelo A, Pagotto U, Pasquali R. Cardiovascular events and mortality in patients with adrenal incidentalomas that are either non-secreting or associated with intermediate phenotype or subclinical Cushing's syndrome: A 15-year retrospective study. Lancet Diabetes Endocrinol 2014; 2: 396-405
    CrossrefPubMedSearch in Google Scholar
  • 10 Reincke M, Fassnacht M, Vath S, Mora P, Allolio B. Adrenal incidentalomas: A manifestation of the metabolic syndrome?. Endocr Res 1996; 22: 757-761
    CrossrefPubMedSearch in Google Scholar
  • 11 Tuna MM, Imga NN, Dogan BA, Yilmaz FM, Topcuoglu C, Akbaba G, Berker D, Guler S. Non-functioning adrenal incidentalomas are associated with higher hypertension prevalence and higher risk of atherosclerosis. J Endocrinol Invest 2014; 37: 765-768
    CrossrefPubMedSearch in Google Scholar
  • 12 Masserini B, Morelli V, Palmieri S, Eller-Vainicher C, Zhukouskaya V, Cairoli E, Orsi E, Beck-Peccoz P, Spada A, Chiodini I. Lipid abnormalities in patients with adrenal incidentalomas: Role of subclinical hypercortisolism and impaired glucose metabolism. J Endocrinol Invest 2015; 38: 623-628
    CrossrefPubMedSearch in Google Scholar
  • 13 Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A, Tabarin A, Terzolo M, Tsagarakis S, Dekkers OM. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 2016; 175: G1-G34
    CrossrefPubMedSearch in Google Scholar
  • 14 Dogruk Unal A, Ayturk S, Aldemir D, Bascil Tutuncu N. Serum Adiponectin Level as a Predictor of Subclinical Cushing's Syndrome in Patients with Adrenal Incidentaloma. Int J Endocrinol 2016; 8519362
    PubMedSearch in Google Scholar
  • 15 Catapano AL, Reiner Z, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman M, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Filardi PP, Riccardi G, Storey RF, Wood D. European Society of C; European Atherosclerosis S. ESC/EAS Guidelines for the management of dyslipidaemias The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis 2011; 217: 3-46
    CrossrefPubMedSearch in Google Scholar
  • 16 American Diabetes Association. Classification and diagnosis of diabetes. Diabetes Care 2016; (Suppl. 01) S13-S22
    PubMedSearch in Google Scholar
  • 17 Papanastasiou L, Pappa T, Samara C, Apostolopoulou G, Tsiavos V, Markou A, Alexandraki K, Piaditis G, Chrousos G, Kaltsas G. Nonalcoholic fatty liver disease in subjects with adrenal incidentaloma. Eur J Clin Invest 2012; 42: 1165-1172
    CrossrefPubMedSearch in Google Scholar
  • 18 Tabuchi Y, Otsuki M, Kasayama S, Kosugi K, Hashimoto K, Yamamoto T, Tsugawa M, Mineo I, Yamada Y, Kurebayashi S, Ohashi M, Umayahara Y, Kouhara H, Nakamura T, Taki H, Matsuoka TA, Imagawa A, Funahashi T, Shimomura I. Clinical and endocrinological characteristics of adrenal incidentaloma in Osaka region, Japan. Endocr J 2016; 63: 29-35
    CrossrefPubMedSearch in Google Scholar
  • 19 Rossi R, Tauchmanova L, Luciano A, Di Martino M, Battista C, Del Viscovo L, Nuzzo V, Lombardi G. Subclinical Cushing's syndrome in patients with adrenal incidentaloma: Clinical and biochemical features. J Clin Endocrinol Metab 2000; 85: 1440-1448
    CrossrefPubMedSearch in Google Scholar
  • 20 Ginsberg HN. Review: Efficacy and mechanisms of action of statins in the treatment of diabetic dyslipidemia. J Clin Endocrinol Metab 2006; 91: 383-392
    CrossrefPubMedSearch in Google Scholar
  • 21 Arnaldi G, Scandali VM, Trementino L, Cardinaletti M, Appolloni G, Boscaro M. Pathophysiology of dyslipidemia in Cushing's syndrome. Neuroendocrinology 2010; 92 (Suppl. 01) 86-90
    CrossrefPubMedSearch in Google Scholar
  • 22 Chiodini I, Morelli V, Salcuni AS, Eller-Vainicher C, Torlontano M, Coletti F, Iorio L, Cuttitta A, Ambrosio A, Vicentini L, Pellegrini F, Copetti M, Beck-Peccoz P, Arosio M, Ambrosi B, Trischitta V, Scillitani A. Beneficial metabolic effects of prompt surgical treatment in patients with an adrenal incidentaloma causing biochemical hypercortisolism. J Clin Endocrinol Metabolism 2010; 95: 2736-2745
    CrossrefPubMedSearch in Google Scholar
  • 23 Iacobone M, Citton M, Viel G, Boetto R, Bonadio I, Mondi I, Tropea S, Nitti D, Favia G. Adrenalectomy may improve cardiovascular and metabolic impairment and ameliorate quality of life in patients with adrenal incidentalomas and subclinical Cushing's syndrome. Surgery 2012; 152: 991-997
    CrossrefPubMedSearch in Google Scholar
  • 24 Giordano R, Guaraldi F, Berardelli R, Karamouzis I, D'Angelo V, Marinazzo E, Picu A, Ghigo E, Arvat E. Glucose metabolism in patients with subclinical Cushing's syndrome. Endocrine 2012; 41: 415-423
    CrossrefPubMedSearch in Google Scholar
  • 25 Dennedy MC, Annamalai AK, Prankerd Smith O, Freeman N, Vengopal K, Graggaber J, Koulouri O, Powlson AS, Shaw A, Halsall DJ, Gurnell M. Low DHEAS: A sensitive and specific test for detection of subclinical hypercortisolism in adrenal incidentalomas. J Clin Endocrinol Metab 2017; 102: 786-792
    PubMedSearch in Google Scholar
  • 26 Chambre C, McMurray E, Baudry C, Lataud M, Guignat L, Gaujoux S, Lahlou N, Guibourdenche J, Tissier F, Sibony M, Dousset B, Bertagna X, Bertherat J, Legmann P, Groussin L. The 10 Hounsfield units unenhanced computed tomography attenuation threshold does not apply to cortisol secreting adrenocortical adenomas. Eur J Endocrinol 2015; 173: 325-332
    CrossrefPubMedSearch in Google Scholar
  • 27 Mosconi C, Vicennati V, Papadopoulos D, Dalmazi GD, Morselli-Labate AM, Golfieri R, Pasquali R. Can imaging predict subclinical cortisol secretion in patients with adrenal adenomas? a CT predictive score. Am J Roentgenol 2017; 209: 122-129
    CrossrefPubMedSearch in Google Scholar
  • 28 Olsen H, Nordenstrom E, Bergenfelz A, Nyman U, Valdemarsson S, Palmqvist E. Subclinical hypercortisolism and CT appearance in adrenal incidentalomas: A multicenter study from Southern Sweden. Endocrine 2012; 42: 164-173
    CrossrefPubMedSearch in Google Scholar
  • 29 Sadler C, Goldfarb M. Risk estimator for adrenal tumor functionality. World J Surg 2014; 38: 2019-2024
    CrossrefPubMedSearch in Google Scholar
  • 30 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-2497
    CrossrefPubMedSearch in Google Scholar
  • 31 Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST, Smith Jr. SC, Watson K, Wilson PW, Eddleman KM, Jarrett NM, LaBresh K, Nevo L, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith Jr. SC, Tomaselli GF. American College of Cardiology/American Heart Association Task Force on Practice G. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 129: S1-S45
    CrossrefPubMedSearch in Google Scholar