Table 7.
Summary of published studies evaluating the effect of adrenalectomy on clinical and biochemical features of autonomous cortisol secretion.
| Proportion of patients with improvement postop | ||||||
|---|---|---|---|---|---|---|
| Study, year (ref.) | Design | Diagnostic criteria DST cortisol nmol/L ACTH pg/mL | Operated patients (n) | Arterial HTN | Weight | Impaired glucose metabolism |
| Perysinakis 2013 (250) | Retrospective no control | DST >50 and 1 of the following: ACTH <2.2 24-h UFC >276 blunted diurnal CCR | 29 | 12/17 | 6/14 | 5/12 |
| Iacobone 2012 (251) | Retrospective | DST >138 ACTH <2.2 high 24-h UFC | 20 | 8/15 | 6/15 | 5/10 |
| Maehana 2012 (252) | Retrospective nonfunctioning No control | DST >50 and 1 of the following: low ACTH, loss of CCR, scintigraphy, low DHEAS | 13 | 5/7 | n/a | 2/2 |
| Guerrieri 2010 (253) | Retrospective | 2 of the following: DST >50, high 24-h UFC ACTH <2.2. | 19 | 12/12 | n/a | n/a |
| Chiodini 2010 (254) | Retrospective | 2 of: the following DST >83, high 24-h UFC, ACTH <2.2. | 25 | n/a | n/a | n/a |
| Toniato 2009 (255) | Prospective randomized | DST >69 and 2 of the following: low ACTH, high 24-h UFC, loss of CCR, low DHEAS | 23 | 12/18 | 3/6 | 5/8 |
| Tsuiki 2008 (243) | Retrospective | DST (8mg) >28 and one of the following: ACTH<2.2, blunted ACTH after CRH, loss of CCR, low DHEAS, scintigraphy | 10 | 5/6 | 0/3 | 2/9 |
| Salcuni 2016 (256) | Retrospective 23 controls refused surgery | DST >138 or 2 of the following DST >83 low ACTH high 24h-UFC | 32 | No change | — | No change |
Adapted from Iacobone et al. (257).
Abbreviations: n/a, not assessed/ available; DST, dexamethasone suppression test; ACTH, adrenocorticotropic hormone; UFC, urinary free cortisol; CCR, cortisol circadian rhythm (ratio of plasma cortisol at 24.00 hours to 08.00 hours >50%); DHEAS, dehydroepiandrosterone sulfate; CRH, corticotropin-releasing hormone.