title: Clinical Benefits of Unilateral Adrenalectomy in Patients with Subclinical Hypercortisolism Due to Adrenal Incidentaloma: Results from a Single Center.
abstract: BACKGROUND
  This study was designed to evaluate the results of unilateral laparoscopic adrenalectomy in patients with subclinical hypercortisolism (SH) due to adrenal incidentaloma (AI) concerning the main cardiometabolic disorders.
  
  
  METHODS
  We have studied between January 2000 to December 2015, 645 patients with AI (283 males and 362 females; mean age 61.9 ± 10 years) and we found 70 patients with SH (27 males and 43 females; mean age 61.9 ± 8.4 years). Twenty-six (37%) SH patients (6 males and 20 females; mean age 58.7 ± 7.1 years) underwent unilateral laparoscopic adrenalectomy, whereas 44 SH patients (21 males and 23 females; mean age 63.9 ± 9.9 years) performed a conservative treatment. All SH patients were evaluated at diagnosis and after follow-up (mean 12 months; range 9-15 months).
  
  
  RESULTS
  In only SH patients undergoing unilateral adrenalectomy we found a statistical significant reduction of the arterial hypertension and metabolic syndrome (p < 0.05, respectively). In particular we observed a reduction of 24-h systolic blood pressure and "non-dipper" pattern (p < 0.05, respectively) evaluated with ambulatory blood pressure monitoring (ABPM).
  
  
  CONCLUSIONS
  Our study confirm the high prevalence of SH in AI, and the unilateral laparoscopic adrenalectomy seemed to have a beneficial effect on some cardiometabolic disorders.
authors.affiliation: Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Viale del Policlinico, 155, 00161, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Petramala
authors.affiliation: Department of Surgery "P. Valdoni", University of Rome, "Sapienza", Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cavallaro
authors.affiliation: Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Viale del Policlinico, 155, 00161, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Galassi
authors.affiliation: Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Viale del Policlinico, 155, 00161, Rome, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Marinelli
authors.affiliation: Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Viale del Policlinico, 155, 00161, Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Tonnarini
authors.affiliation: Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Viale del Policlinico, 155, 00161, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Concistrè
authors.affiliation: Department of Surgery "P. Valdoni", University of Rome, "Sapienza", Rome, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Costi
authors.affiliation: Department of Surgery "P. Valdoni", University of Rome, "Sapienza", Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bufi
authors.affiliation: Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Viale del Policlinico, 155, 00161, Rome, Italy.
authors.forename: Piernatale
authors.initials: P
authors.lastname: Lucia
authors.affiliation: Nuclear Medicine Section, Department of Radiology, University of Rome, "Sapienza", Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Vincentis
authors.affiliation: Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Viale del Policlinico, 155, 00161, Rome, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Iannucci
authors.affiliation: Department of Surgery "P. Valdoni", University of Rome, "Sapienza", Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: De Toma
authors.affiliation: Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Viale del Policlinico, 155, 00161, Rome, Italy. claudio.letizia@uniroma1.it.
authors.forename: Claudio
authors.identifier: http://orcid.org/0000-0003-4397-0624
authors.initials: C
authors.lastname: Letizia
mesh_terms: D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D062186:Arterial Pressure / Q000187:drug effects; D058070:Asymptomatic Diseases; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D003480:Cushing Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D033162:Incidental Findings; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012384:Rome; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Ambulatory blood pressure monitoring; Cardiometabolic disorders; Subclinical hypercortisolism due to adrenal incidentaloma; Unilateral laparoscopy adrenalectomy