• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Endocrinology

Autonomous cortisol secretion correlated with mortality for adrenal incidentalomas

byDavid XiangandHarsh Shah
June 27, 2021
in Endocrinology, Surgery
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Adrenal incidentalomas patients with severely elevated cortisol levels following a dexamethasone suppression test were shown to have a three-time increase in the risk of mortality compared to patients without autonomous cortisol secretion.

2. The relationship between cortisol level and mortality was found to be linear until a cortisol concentration, following a dexamethasone suppression test, of 200 nmol/L.

Evidence Rating Level: 2 (Good)

Study Rundown: Patients with incidentally detected adrenal lesions, or adrenal incidentalomas (AIs), often exhibit autonomous cortisol secretion (ACS) despite a lack of overt Cushing syndrome. Severe hypercortisolism has been strongly linked to increased mortality; however, the extent to which mortality risk is increased in patients with AIs remains unclear. This study investigated the relationship between the degree of ACS, based on plasma cortisol level following an overnight dexamethasone suppression test (cortisolDST), and mortality. Compared to patients in the group with the lowest cortisol concentration, those in the two highest groups had a twofold and threefold increase, respectively, in mortality within 5 to 10 years. The study was limited by the results were not based on verified autonomous cortisol secretion, therefore, the association between cortisol secretion and mortality may be underestimated. Nonetheless, the study’s findings are significant as they implicated ACS as a potentially underappreciated risk factor for death that should be considered during treatment planning for patients with AIs.

Click here to read the study in Annals of Internal Medicine

Relevant Reading: Increased mortality in patients with adrenal incidentalomas and autonomous cortisol secretion: a 13-year retrospective study from one center

In-Depth [retrospective cohort]: This retrospective study utilized data from all 1,048 patients from two hospitals in southern Sweden. Patients included in the study were at least 18 years of age with a previously unknown AI and were referred to the departments of endocrinology at the two hospitals. Patients living outside the catchment areas of the two hospitals were not included in the study. All patients were administered one milligram of dexamethasone followed by a blood sample collection for cortisol nine hours later. Patients were sorted into one of four groups based on cortisolDST: <50 nmol/L, 50–82 nmol/L, 83–137 nmol/L, and ≥138 nmol/L. The primary outcome was all-cause mortality. During a median follow-up of 6.38 years, 170 patients (16.2%) died. After adjusting for predefined covariates, patients with cortisolDST of 83 nmol/L and higher had a two- to three-fold increase in all-cause mortality compared to a cortisolDST below 50 nmol/L. Specifically, the hazard ratio (HR) for the 83–137 nmol/L group was 2.33 (95% confidence interval [CI], 1.53 to 3.53) and 2.87 (95% CI, 1.74 to 4.74) for the ≥138 nmol/L group. No difference in all-cause mortality was detected between the 50–82 nmol/L and <50 nmol/L groups during the study (HR, 1.17; 95% CI, 0.79 to 1.73). Cardiovascular disease was the only statistically significant contributor to increased mortality among the >83 nmol/L composite group (HR, 2.33; 95% CI, 1.27 to 4.28). Furthermore, mortality was independent of AI size, bilateralism, and basal corticotropin level; however, it was associated with dehydroepiandrosterone level (HR for DHEAS <1.04 umol/L, 1.47; 95% CI, 1.05 to 2.05). Overall, patients with moderately or severely elevated cortisol levels following a dexamethasone suppression test had an increased mortality risk.

RELATED REPORTS

Physical activity improves sleep quality and cortisol regulation

Wellness Check: Sleep

Low income associated with increased BMI and chronic stress

Image: PD

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: adrenal incidentalomacortisoldehydroepiandrosteronedexamethasonesuppression test
Previous Post

Nicotine replacement therapy for expectant fathers

Next Post

2 Minute Medicine Rewind June 28, 2021

RelatedReports

Increased number of daily steps linked with decreased mortality in older women
Endocrinology

Physical activity improves sleep quality and cortisol regulation

January 20, 2023
Decline in adolescent sleep duration over past 20 years
Wellness

Wellness Check: Sleep

January 19, 2023
Disparities in type 1 diabetes not explained by socioeconomic status alone
Chronic Disease

Low income associated with increased BMI and chronic stress

October 10, 2022
ARMC5 mutation identified in patients with macronodular adrenal hyperplasia
Chronic Disease

Low prevalence of adrenal tumors in the general adult screening population

September 19, 2022
Next Post
Beta-blockers associated with worse outcomes in non-cardiac perioperative settings

2 Minute Medicine Rewind June 28, 2021

Lessons from real-world implementation of lung cancer screening

Postoperative radiotherapy in pIIIA-N2 Non–Small Cell Lung Cancer after resection and chemotherapy

Female incontinence associated with physical activity

Use of cloth face masks may reduce exercise performance because of discomfort

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Abnormal menstruation may be associated with worse cardiometabolic outcomes later in life
  • Past infection with pre-omicron variants of COVID-19 protects against re-infection
  • No difference in complete expulsion of intrauterine device between early and standard interval postpartum placement
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options