title: Steroid Profiling by LC-MS/MS in Nonsecreting and Subclinical Cortisol-Secreting Adrenocortical Adenomas.
abstract: BACKGROUND
  Long-term follow-up studies revealed that patients with subclinical hypercortisolism (SH) due to adrenocortical adenomas have an increased incidence of cardiovascular diseases and mortality. No studies have yet investigated the steroid profile and its implications in patients with SH.
  
  
  OBJECTIVE
  The objective of the study was to analyze the steroid profile by liquid chromatography-tandem mass spectrometry in sera from patients with unilateral adrenocortical adenomas.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  The study was conducted at an outpatient clinic.
  
  
  METHODS
  Patients with adrenocortical adenomas (nonsecreting, n = 66; SH, n = 28) and 188 age- and sex-matched controls drawn from the general population participated in the study.
  
  
  METHODS
  Cortisol, 21-deoxycortisol, 11-deoxycortisol, 17-hydroxyprogesterone, androstenedione, dehydroepiandrosterone, T, progesterone, 11-deoxycorticosterone, and corticosterone in the basal condition and after a 1-24 ACTH test, and clinical data were measured.
  
  
  RESULTS
  Patients with SH showed lower basal and 1-24 ACTH-stimulated levels of dehydroepiandrosterone and androstenedione than those with nonsecreting adenomas and controls. T was also lower in SH females. Receiver-operating characteristic curves showed that androgens had good accuracy in predicting SH (sensitivity and specificity were 71% and 76% for dehydroepiandrosterone and 69% and 61% for androstenedione, respectively). Increased cortisol and reduced dehydroepiandrosterone levels were independently associated with increased waist circumference. Cortisol was also independently associated with increased number of cardiovascular risk factors in SH patients. After 1-24 ACTH stimulation, the SH patients also showed increased production of 21-deoxycortisol and 11-deoxycorticosterone.
  
  
  CONCLUSIONS
  Liquid chromatography-tandem mass spectrometry steroid profile performed for the first time in sera from patients with adrenocortical adenomas showed impaired secretion of several steroids in SH patients. This fingerprint can help in better characterizing the functional status of these tumors.
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Di Dalmazi
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Flaminia
authors.initials: F
authors.lastname: Fanelli
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Mezzullo
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Casadio
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Rinaldi
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Garelli
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Giampalma
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Mosconi
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Golfieri
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Vicennati
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Uberto
authors.initials: U
authors.lastname: Pagotto
authors.affiliation: Endocrinology Unit (G.D.D., F.F., M.M., E.C., E.R., S.G., V.V., U.P., R.P.), Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, and Diagnostic and Interventional Radiology Unit (E.G., C.M., R.G.), Department of Diagnostic and Preventive Medicine, South Orsola-Malpighi Hospital, Alma Mater University of Bologna, 40138 Bologna, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Pasquali
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000306:Adrenal Cortex Neoplasms / Q000378:metabolism* / Q000473:pathology; D018246:Adrenocortical Adenoma / Q000378:metabolism* / Q000473:pathology; D000368:Aged; D000735:Androstenedione / Q000097:blood; D003350:Cortodoxone / Q000097:blood; D003366:Cosyntropin / Q000097:blood; D003430:Cross-Sectional Studies; D003687:Dehydroepiandrosterone / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D053719:Tandem Mass Spectrometry
chemical_list: D003366:Cosyntropin; D000735:Androstenedione; D003687:Dehydroepiandrosterone; C003556:21-deoxycortisol; D019326:17-alpha-Hydroxyprogesterone; D003350:Cortodoxone; D006854:Hydrocortisone