title: Clinical and biochemical impact of BCL1 polymorphic genotype of the glucocorticoid receptor gene in patients with adrenal incidentalomas.
abstract: BACKGROUND
  Adrenal incidentaloma (AI) is a common clinical problem. Subtle hormonal abnormalities are present in a substantial proportion of patients. BCL1 gene polymorphism of the glucocorticoid receptor (GR) is associated with increased sensitivity to glucocorticoid action. The genotype- phenotype associations of this polymomorphism in patients presenting with AI has not been extensively investigated.
  
  
  OBJECTIVE
  A cross-sectional study in secondary/tertiary care centers.
  
  
  METHODS
  Ninety-five subjects with AI were genotyped for the BCL1 GR gene polymorphism. Patients underwent an oral glucose tolerance test and a dexamethasone suppression test (DST). The presence of subclinical hypercortisolism, features of metabolic syndrome, and osteoporosis/ osteopenia were also assessed.
  
  
  RESULTS
  No significant differences in markers of adrenal function between BCL1 carriers and non-carriers were revealed. Also, no difference was found in the features of metabolic syndrome, as well as in bone metabolism and density between these 2 groups. However, DST suppressor patients belonged more frequently to the BCL1 carriers group (41 out of 69 patients, 59.4% vs 9 out of 26 patients, 34.6%, p=0.0039), had smaller total adenoma size (2.4±0.2 cm vs 3.5±0.4 cm, p=0.04), and lower incidence of bilateral adrenal masses (18.8% vs 46.2%, p=0.01).
  
  
  CONCLUSIONS
  AI patients who also carry the polymorphic BCL1 variant exhibit smaller size adrenal nodules. Those AI patients with complete DST suppression had a higher incidence of the polymorphic BCL1 variant. However, this study failed to demonstrate any significant impact of BCL1 GR polymorphism on the frequency of cortisol-dependent co-morbidities in patients with AI.
authors: Department of Endocrinology, Evangelismos Hospital, 45-47 Ipsilantous St., Athens, Greece.
authors: M
authors: M
authors: Tzanela
authors: E
authors: E
authors: Mantzou
authors: K
authors: K
authors: Saltiki
authors: M
authors: M
authors: Tampourlou
authors: N
authors: N
authors: Kalogeris
authors: D
authors: D
authors: Hadjidakis
authors: S
authors: S
authors: Tsagarakis
authors: M
authors: M
authors: Alevizaki
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood* / Q000235:genetics* / Q000473:pathology; D000368:Aged; D003430:Cross-Sectional Studies; D019938:Cyclin D1 / Q000235:genetics*; D005260:Female; D014644:Genetic Variation / Q000235:genetics; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D011965:Receptors, Glucocorticoid / Q000235:genetics*
chemical_list: C530104:CCND1 protein, human; D011965:Receptors, Glucocorticoid; D019938:Cyclin D1