Endocrine Abstracts

The diagnosis of subclinical hypercortisolemia in patients with incidental adrenal tumors remains a challenge, as there are no unambiguous criteria for diagnosis. The discovery of a substance whose secretion increases under the influence of cortisol would make it easier to make therapeutic decisions. Hypercortisolism causes a change in the distribution of adipose tissue, so it can be assumed that it also affects secretion of proteins secreted by adipocytes (adipokines). The aim of the study was to assess adipocyte concentration of selected adipokines, ie chemerin, A-FABP, omentine and visfatin depending on the degree of suppression of cortisol secretion in the nocturnal dexamethasone suppression test, and the occurrence of metabolic disorders likely to have relationship with excessive secretion of cortisol. The study group consisted of 100 patients with adrenal incidentalomas, 58 women and 42 men, middle-aged 62 (±8.4) years old, who were hospitalized in the Department of Endocrinology and Diabetology at University Hospital No. 1 in Bydgoszcz. On the basis of the night-time inhibition test with dexamethasone, the patients were divided into two groups: with suppressed secretion of cortisol, i.e. ≤1.8 mg/dl, this group was defined as DST ≤1.8 (60 people) and with possible excessive secretion of cortisol, i.e. >1.8 μg/dl, this group was defined as DST>1.8 (40 people). The control group consisted of 36 people, who showed no pathology in the adrenal glands in imaging studies and excluded hypercortisolemia based on the dexamethasone suppression test (cortisol ≤1.8 μg /dl). There were no statistically significant differences in the concentration of A-FABP, omentine and visfatin between the groups. In contrast, the concentration of chemerin was statistically significantly higher in the DST > 1.8 group compared to the DST ≤1,8 group and the control group (P=0.0027, P=0.0006). No differences were found in the concentration of A-FABP, omentine and visfatin between the: DST>1.8, DST≤1,8 and control group taking into account the occurrence of carbohydrate metabolism disorders, hypertension, dyslipidemia or metabolic syndrome. On the other hand, the concentration of chemerin in patients from the DST>1.8 group with accompanying metabolic disorders (except for glucose tolerance disorders) was significantly higher compared to the remaining groups, regardless of the diagnosis of these disorders. In summary, the presented study showed that high concentration of chemerin can act as a predictor of excessive autonomic secretion of cortisol, especially in patients with known hypertension, lipid profile disorders or metabolic syndrome.