Akademik Veri Yönetim Sistemi
BMC ENDOCRINE DISORDERS, cilt.25, sa.1, 2025 (SCI-Expanded, Scopus)
Context Adrenal incidentaloma (AI) guidelines classify patients with suppressed 1 mg dexamethasone suppression test cortisol (F) below 50nmol/l as non-functioning in terms of cortisol autonomy and denies the necessity of metabolic follow-up. However, cardiometabolic risk and disturbed quality of life was shown in those patients. We aimed to establish daily cortisol exposure by salivary cortisol sampling at three different time frames and evaluate whether patients with suppressed (F) are exposed to cortisol excess. Design Cross-sectional and prospective. Patients In 138 AI patients referred to our unit, 101 patients were enrolled. We included healthy volunteers without any adrenal disorders (n = 30) and patients with Cushing's syndrome evaluated during the study timeline (n = 16). Adrenal incidentaloma patients were divided into categories with respect to (F). Measurements Anthropometric characteristics, previous history of cardiovascular events, plasma corticotrophin (ACTH), serum dehydroepiandrostenadione-sulfate (DHEAS) and (F) were recorded. Saliva collection for the assessment of cortisol concentration was performed at the morning (SLCMN), afternoon (SLCAN) and late night (SLCLN). Results SLCAN and SLCLN of AI patients, irrespective of their F levels, were significantly increased when compared to healthy controls. Further analysis showed that SLCAN and SLCLN concentrations were significantly elevated in patients with F [25-49nmol/l] compared to healthy controls. Diurnal rhythm of cortisol had a similar pattern in healthy controls and all AI subjects irrespective of their F category while the amplitude of secretion was concordant with F. Conclusions Adrenal incidentaloma patients categorized as non-functioning by the current criteria of (F), could feature an increased exposure cortisol secretion.