ECE2020 Audio ePoster Presentations Diabetes, Obesity, Metabolism and Nutrition (285 abstracts)
The quantitative relationship between Autonomous cortisol secretion, Dysglycemia and the Metabolic syndrome
Jonathan Bleier 1,2 , Gadi Shlomai 1,2,3 , Boris Fishman 1,2 , Zohar Dotan 2,4 , Barak Rosenzweig 2,4 & Amir Tirosh 2,3
1Sheba Medical Center, Internal Medicine D, Ramat gan, Israel; 2Tel Aviv University, Sackler faculty of medicine, Tel Aviv, Israel; 3Sheba Medical Center, The Institute of Endocrinology, Diabetes and Metabolism, Ramat Gan, Israel; 4Sheba Medical Center, Department of Urology, Ramat Gan, Israel
Objective: Autonomous cortisol secretion (ACS) is the most common endocrine abnormality in the evaluation of adrenal incidentalomas. The categorization of ACS is derived from a 1 mg dexamethasone suppression test (DST). Impaired DST is associated with several metabolic derangements. In this study we assess the correlation between post-DST cortisol level, analyzed as a continuous parameter, and indices of glycemic metabolism.
Study design: We prospectively collected data of 1976 patients evaluated for adrenal incidentalomas in a large tertiary medical center between December 1st, 2017 and August 31st, 2019. 73 patients completed the evaluation process. Post-DST cortisol levels were analyzed for correlation with various metabolic parameters, including fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) among the general cohort and for subgroups stratified by the number of metabolic syndrome (MS) criteria.
Results: Post-DST cortisol demonstrated a linear correlation with FPG and HbA1c across its entire cortisol range (R = 0.51 and 0.41, respectively, P ≤ 0.01). The correlation between post-DST cortisol and FPG was strengthened with increased number of metabolic syndrome criteria. Patients with 4 MS criteria show a stronger correlation (R = 0.92) compared to patients with only a single criterion (R = 0.509). Furthermore, mean post-DST cortisol levels increased as the number of MS criteria accumulated.
Conclusion: Post-DST cortisol should be viewed as a continuous parameter in risk stratification algorithms for development of the MS and particularly dysglycemia.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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