| THE FUNCTIONAL STATUS OF INCIDENTALLY DISCOVERED BILATERAL ADRENAL LESIONS. | |
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MedLine Citation:
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PMID: 21521282 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objective: To investigated autonomous cortisol and aldosterone secretion and insulin resistance (IR) indices, in patients with incidentally discovered bilateral adrenal lesions (BA). Patients: Thirty-six patients with BA, 113 patients with unilateral adrenal incidentalomas (UA) and 89 healthy subjects (C) with normal adrenal imaging. Measurements: All participants underwent adrenal imaging, baseline biochemical and hormonal measurements and the following investigations on consecutive days, 1) A 2-hour Oral Glucose tolerance test (OGTT) (75g) with glucose and insulin measurements every 30 min. 2). An ACTH stimulation-test with intravenous (i.v.) bolus administration of 250 μg of ACTH (1-24) and measurement of serum cortisol and aldosterone before and after 30 and 60 minutes. 3) A Low dose dexamethasone suppression test (LDDST) (0.5 mg of dexamethasone every 6-hours for 2 days) with cortisol measurement 6 hours after the last dexamethasone dose 4) A NaCl (0.9%) infusion test (PD-SIT) (2lt of NaCl 0.9% iv in 4 hours) following the LDDST, with aldosterone measurement at the end of the test. Results: Cortisol and aldosterone cut-offs based on the mean+2SD values obtained from the C group following the LDDST and PD-SITs were calculated (34.11 nmol/L and 74.83 pmol/L respectively). Based on the above cut-offs autonomous cortisol and aldosterone secretion was found in 42.5% and 15.9% of patients with UA, and in 41.7% and 19.4% of patients with BA respectively. In addition, 17.7% of patients with UA, and 19.4% of patients with BA had concomitant autonomous cortisol and aldosterone secretion. Cortisol and aldosterone levels following the LDDST and PD-SIT were significantly higher in the BA compared to the UA group respectively. Furthermore, patients with BA had more pronounced glucose levels and insulin resistance (IR) indices compared to patients with UA. Conclusions: Patients with BA have more pronounced autonomous cortisol and aldosterone secretion and glucose metabolism alterations than patients with UA. Further studies are needed to evaluate the potential long-term consequences of these findings. |
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Authors:
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Ioannis I Androulakis; Gregory A Kaltsas; Athina Markou; Ermioni Tseniklidi; Paraskevi Kafritsa; Theodora Pappa; Lambrini Papanastasiou; George P Piaditis |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-14 |
Journal Detail:
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Title: Clinical endocrinology Volume: - ISSN: 1365-2265 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-4-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0346653 Medline TA: Clin Endocrinol (Oxf) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Blackwell Publishing Ltd. |
Affiliation:
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Department of Endocrinology and Diabetes, General Hospital of Athens "G. Genimatas" Endocrine unit, Department of Pathophysiology, Medical School, University of Athens. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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