The Steroid Profile of Adrenal Incidentalomas: Subtyping Subjects With High Cardiovascular Risk

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Mass Spectrometry

Background:

• Steroid profiling using mass spectrometry aids in adrenal tumor diagnosis and subtyping.
• Adrenal incidentalomas require careful evaluation for potential health implications.

Purpose of the Study:

• To investigate steroid profiles and their cardiovascular correlates in patients with nonsecreting (NS) adrenal incidentalomas and autonomous cortisol secretion (ACS).

Main Methods:

• A cohort study of 302 patients with adrenal incidentalomas was conducted.
• Steroid panels were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS).
• Clinical and cardiovascular data were collected over a mean follow-up of 39 months.

Main Results:

• Patients with ACS showed distinct steroid profiles compared to NS groups, with altered cortisol, 11-deoxycortisol, corticosterone, and dehydroepiandrosterone levels.
• Reduced suppression of post-dexamethasone suppression test (DST) cortisol and corticosterone was observed in ACS patients.
• Post-DST cortisol and corticosterone levels were associated with a higher prevalence of severe/resistant hypertension and cardiovascular events.

Conclusions:

• Steroid profiles of adrenal incidentalomas vary with functional status and adrenal morphology.
• These profiles have significant implications for patients' cardiovascular status, particularly in ACS cases.