Cargando…

The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors

BACKGROUND: Similarly to cortisol-secreting adrenal tumors, also non-functioning adrenal tumors (NFAT) may be associated with an increased cardiovascular risk. We assessed in NFAT patients: (i) the association between hypertension (HT), diabetes mellitus (DM), obesity (OB), dyslipidemia (DL) and car...

Descripción completa

Detalles Bibliográficos
Autores principales: Favero, Vittoria, Aresta, Carmen, Parazzoli, Chiara, Cairoli, Elisa, Eller-Vainicher, Cristina, Palmieri, Serena, Salcuni, Antonio Stefano, Arosio, Maura, Persani, Luca, Scillitani, Alfredo, Morelli, Valentina, Chiodini, Iacopo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155432/
https://www.ncbi.nlm.nih.gov/pubmed/37131218
http://dx.doi.org/10.1186/s12933-023-01836-1
_version_ 1785036327437205504
author Favero, Vittoria
Aresta, Carmen
Parazzoli, Chiara
Cairoli, Elisa
Eller-Vainicher, Cristina
Palmieri, Serena
Salcuni, Antonio Stefano
Arosio, Maura
Persani, Luca
Scillitani, Alfredo
Morelli, Valentina
Chiodini, Iacopo
author_facet Favero, Vittoria
Aresta, Carmen
Parazzoli, Chiara
Cairoli, Elisa
Eller-Vainicher, Cristina
Palmieri, Serena
Salcuni, Antonio Stefano
Arosio, Maura
Persani, Luca
Scillitani, Alfredo
Morelli, Valentina
Chiodini, Iacopo
author_sort Favero, Vittoria
collection PubMed
description BACKGROUND: Similarly to cortisol-secreting adrenal tumors, also non-functioning adrenal tumors (NFAT) may be associated with an increased cardiovascular risk. We assessed in NFAT patients: (i) the association between hypertension (HT), diabetes mellitus (DM), obesity (OB), dyslipidemia (DL) and cardiovascular events (CVE) and cortisol secretion; (ii) the cut-off of the cortisol secretion parameters for identifying NFAT patients with a worse cardiometabolic profile. PATIENTS AND METHODS: In 615 NFAT patients (with cortisol levels after 1 mg overnight dexamethasone suppression test, F-1mgDST < 1.8 µg/dL [50 nmol/L]) F-1mgDST and adrenocorticotroph hormone (ACTH) levels and data on HT, DM, OB, DL and CVEs prevalence were retrospectively collected. RESULTS: HT, DM and HT plus DM were associated with F-1mgDST levels (area under the ROC curve: 0.588 ± 0.023, 0.610 ± 0.028, 0.611 ± 0.033, respectively, p < 0.001 for all comparisons) but not with ACTH. The cut-off for identifying patients with either HT or DM or HT plus DM was set at ≥ 1.2 µg/dL (33 nmol/L). As compared with patients with F-1mgDST < 1.2 µg/dL (n = 289), patients with F-1mgDST 1.2–1.79 µg/dL (33–49.4 nmol/L) (n = 326) had lower ACTH levels (17.7 ± 11.9 vs 15.3 ± 10.1 pg/mL, respectively, p = 0.008), older age (57.5 ± 12.3 vs 62.5 ± 10.9 years, respectively, p < 0.001), and higher prevalence of HT (38.1% vs 52.5% respectively p < 0.001), DM (13.1% vs 23.3%, respectively, p = 0.001), HT plus DM (8.3% vs 16.9%, respectively, p < 0.002) and CVE (3.2% vs 7.3%, respectively, p = 0.028). F-1mgDST 1.2–1.79 µg/dL was associated with either HT (odd ratio, OR, 1.55, 95% confidence interval, 95% CI 1.08–2.23, p = 0.018) or DM (OR 1.60, 95% CI 1.01–2.57, p = 0.045) after adjusting for age, gender, OB, DL, and DM (for HT) or HT (for DM), and with the presence of HT plus DM (OR 1.96, 95% CI 1.12–3.41, p = 0.018) after adjusting for age, gender, OB and DL. CONCLUSIONS: In NFAT patients, F-1mgDST 1.2–1.79 µg/dL seems to be associated with a higher prevalence of HT and DM and a worse cardiometabolic profile, even if the poor accuracy of these associations suggests caution in interpreting these results.
format Online
Article
Text
id pubmed-10155432
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-101554322023-05-04 The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors Favero, Vittoria Aresta, Carmen Parazzoli, Chiara Cairoli, Elisa Eller-Vainicher, Cristina Palmieri, Serena Salcuni, Antonio Stefano Arosio, Maura Persani, Luca Scillitani, Alfredo Morelli, Valentina Chiodini, Iacopo Cardiovasc Diabetol Research BACKGROUND: Similarly to cortisol-secreting adrenal tumors, also non-functioning adrenal tumors (NFAT) may be associated with an increased cardiovascular risk. We assessed in NFAT patients: (i) the association between hypertension (HT), diabetes mellitus (DM), obesity (OB), dyslipidemia (DL) and cardiovascular events (CVE) and cortisol secretion; (ii) the cut-off of the cortisol secretion parameters for identifying NFAT patients with a worse cardiometabolic profile. PATIENTS AND METHODS: In 615 NFAT patients (with cortisol levels after 1 mg overnight dexamethasone suppression test, F-1mgDST < 1.8 µg/dL [50 nmol/L]) F-1mgDST and adrenocorticotroph hormone (ACTH) levels and data on HT, DM, OB, DL and CVEs prevalence were retrospectively collected. RESULTS: HT, DM and HT plus DM were associated with F-1mgDST levels (area under the ROC curve: 0.588 ± 0.023, 0.610 ± 0.028, 0.611 ± 0.033, respectively, p < 0.001 for all comparisons) but not with ACTH. The cut-off for identifying patients with either HT or DM or HT plus DM was set at ≥ 1.2 µg/dL (33 nmol/L). As compared with patients with F-1mgDST < 1.2 µg/dL (n = 289), patients with F-1mgDST 1.2–1.79 µg/dL (33–49.4 nmol/L) (n = 326) had lower ACTH levels (17.7 ± 11.9 vs 15.3 ± 10.1 pg/mL, respectively, p = 0.008), older age (57.5 ± 12.3 vs 62.5 ± 10.9 years, respectively, p < 0.001), and higher prevalence of HT (38.1% vs 52.5% respectively p < 0.001), DM (13.1% vs 23.3%, respectively, p = 0.001), HT plus DM (8.3% vs 16.9%, respectively, p < 0.002) and CVE (3.2% vs 7.3%, respectively, p = 0.028). F-1mgDST 1.2–1.79 µg/dL was associated with either HT (odd ratio, OR, 1.55, 95% confidence interval, 95% CI 1.08–2.23, p = 0.018) or DM (OR 1.60, 95% CI 1.01–2.57, p = 0.045) after adjusting for age, gender, OB, DL, and DM (for HT) or HT (for DM), and with the presence of HT plus DM (OR 1.96, 95% CI 1.12–3.41, p = 0.018) after adjusting for age, gender, OB and DL. CONCLUSIONS: In NFAT patients, F-1mgDST 1.2–1.79 µg/dL seems to be associated with a higher prevalence of HT and DM and a worse cardiometabolic profile, even if the poor accuracy of these associations suggests caution in interpreting these results. BioMed Central 2023-05-02 /pmc/articles/PMC10155432/ /pubmed/37131218 http://dx.doi.org/10.1186/s12933-023-01836-1 Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Favero, Vittoria
Aresta, Carmen
Parazzoli, Chiara
Cairoli, Elisa
Eller-Vainicher, Cristina
Palmieri, Serena
Salcuni, Antonio Stefano
Arosio, Maura
Persani, Luca
Scillitani, Alfredo
Morelli, Valentina
Chiodini, Iacopo
The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors
title The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors
title_full The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors
title_fullStr The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors
title_full_unstemmed The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors
title_short The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors
title_sort degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155432/
https://www.ncbi.nlm.nih.gov/pubmed/37131218
http://dx.doi.org/10.1186/s12933-023-01836-1
work_keys_str_mv AT faverovittoria thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT arestacarmen thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT parazzolichiara thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT cairolielisa thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT ellervainichercristina thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT palmieriserena thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT salcuniantoniostefano thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT arosiomaura thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT persaniluca thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT scillitanialfredo thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT morellivalentina thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT chiodiniiacopo thedegreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT faverovittoria degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT arestacarmen degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT parazzolichiara degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT cairolielisa degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT ellervainichercristina degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT palmieriserena degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT salcuniantoniostefano degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT arosiomaura degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT persaniluca degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT scillitanialfredo degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT morellivalentina degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors
AT chiodiniiacopo degreeofcortisolsecretionisassociatedwithdiabetesmellitusandhypertensioninpatientswithnonfunctioningadrenaltumors