The size of adrenal incidentalomas correlates with insulin resistance. Is there a cause-effect relationship?

被引:41
|
作者
Muscogiuri, Giovanna [1 ]
Sorice, Gian Pio
Prioletta, Annamaria
Mezza, Teresa
Cipolla, Clelia
Salomone, Enrica
Giaccari, Andrea [2 ]
Pontecorvi, Alfredo
Della Casa, Silvia
机构
[1] Univ Cattolica Sacro Cuore, Policlin A Gemelli, I-00168 Rome, Italy
[2] Fdn Don C Gnocchi, Milan, Italy
关键词
SUBCLINICAL CUSHINGS-SYNDROME; GROWTH-FACTOR-I; METABOLIC SYNDROME; CARDIOVASCULAR RISK; GLUCOSE; HYPERCORTISOLISM; RECEPTORS; SECRETION; FEATURES;
D O I
10.1111/j.1365-2265.2010.03928.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
P>Context Adrenal incidentalomas (AI) have often been associated with a high prevalence of insulin resistance (IR) and cardiovascular risk factors, although direct measurement of insulin sensitivity (IS) has never been carried out. Objective We aimed to investigate whether the morphological and hormonal features of AI correlate with the presence and severity of IR, using the hyperinsulinaemic euglycaemic clamp (HEC). Design and Measurements Forty patients with AI (22 women) with a mean age of 58 center dot 5 +/- 11 center dot 1 years underwent hormonal and morphological evaluation. Nineteen patients with AI without known history of diabetes mellitus (DM) or impaired glucose tolerance (IGT) and 17 matched controls underwent oral glucose tolerance test (OGTT) and hyperinsulinaemic euglycaemic clamp (HEC). Results Diabetes mellitus was observed in 13 patients (33%), while three (8%) had IGT. Thirty-one of the AI were nonfunctioning (82 center dot 5%), whereas two (5%) secreted cortisol (Cushing's syndrome) and seven (12 center dot 5%) showed subclinical secretion of cortisol. The 19 patients with nonfunctioning AI were more insulin resistant than controls (glucose up-take: 4 center dot 58 +/- 1 center dot 80 vs 5 center dot 85 +/- 2 center dot 48 mg/kg/min respectively; P = 0 center dot 01); IS was inversely related to the mass size (r = -0 center dot 57; P = 0 center dot 04), free urinary cortisol (r = -0 center dot 68; P = 0 center dot 01), serum cortisol after 1-mg dexamethasone suppression (-0 center dot 65; P = 0 center dot 02) and percentage of trunk fat mass (-0 center dot 77; P = 0 center dot 02) and directly related to serum adreno cortico tropic hormone (ACTH) (r = 0 center dot 62; P = 0 center dot 03). After performing multivariate regression, the mass size was found to be the most powerful predictor of IR. Conclusion Our study showed a high prevalence of insulin resistance in patients with nonfunctioning AI and suggests its possible involvement in AI growth.
引用
收藏
页码:300 / 305
页数:6
相关论文
共 50 条
  • [1] Insulin resistance and metabolic syndrome in patients with nonfunctioning adrenal incidentalomas: a cause-effect relationship?
    Peppa, Melpomeni
    Boutati, Eleni
    Koliaki, Chrysi
    Papaefstathiou, Nasos
    Garoflos, Efstathios
    Economopoulos, Theofanis
    Hadjidakis, Dimitrios
    Raptis, Sotirios A.
    [J]. METABOLISM-CLINICAL AND EXPERIMENTAL, 2010, 59 (10): : 1435 - 1441
  • [2] Luteinizing hormone and insulin resistance in menopausal patients with adrenal incidentalomas: The cause-effect relationship?
    Marina, Ljiljana V.
    Ivovic, Miomira
    Tancic-Gajic, Milina
    Arizanovic, Zorana
    Rakovic, Dragana
    Milin-Lazovic, Jelena
    Kendereski, Aleksandra
    Micic, Dragan
    Vujovic, Svetlana
    [J]. CLINICAL ENDOCRINOLOGY, 2018, 88 (04) : 541 - 548
  • [3] Insulin resistance and adrenal incidentalomas: A bidirectional relationship
    Sydney, Guy I.
    Ioakim, Kalliopi J.
    Paschou, Stavroula A.
    [J]. MATURITAS, 2019, 121 : 1 - 6
  • [4] Non-alcoholic fatty liver and insulin resistance: a cause-effect relationship?
    Bugianesi, E
    Zannoni, C
    Vanni, E
    Marzocchi, R
    Marchesini, G
    [J]. DIGESTIVE AND LIVER DISEASE, 2004, 36 (03) : 165 - 173
  • [5] Exploring Cause-Effect Relationship
    Kaw, Mushtaq A.
    [J]. STRATEGIC ANALYSIS, 2016, 40 (04) : 271 - 290
  • [6] Pathophysiological Link between Insulin Resistance and Adrenal Incidentalomas
    Higgs, Jordan A.
    Quinn, Alyssa P.
    Seely, Kevin D.
    Richards, Zeke
    Mortensen, Shad P.
    Crandall, Cody S.
    Brooks, Amanda E.
    [J]. INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 2022, 23 (08)
  • [7] Cause-effect relationship between the hepatitis C virus and insulin resistance at the time of direct antiviral therapy
    Negro, Francesco
    [J]. GUT, 2010, 59 (12) : 1590 - 1591
  • [8] Relationship between thyroid nodules and non-functioning adrenal incidentalomas and their association with insulin resistance
    Arduc, Ayse
    Isik, Serhat
    Ozuguz, Ufuk
    Tutuncu, Yasemin Ates
    Kucukler, Ferit Kerim
    Ozcan, Hatice Nursun
    Berker, Dilek
    Guler, Serdar
    [J]. ENDOCRINE RESEARCH, 2014, 39 (03) : 99 - 104
  • [9] Endometriosis and infertility - A cause-effect relationship?
    Barbieri, RL
    Missmer, S
    [J]. ENDOMETRIOSIS: EMERGING RESEARCH AND INTERVENTION STRATEGIES, 2002, 955 : 23 - 36
  • [10] ESTIMATION OF CAUSE-EFFECT RELATIONSHIP UNDER NOISE
    PREKOPA, A
    [J]. JOURNAL OF APPLIED PROBABILITY, 1994, 31A : 343 - 350