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Adrenal incidentalomas occur in ≈5% of the population, and some incidentalomas autonomously secrete cortisol. Whether autonomous cortisol secretion (without overt Cushing syndrome) leads to adverse outcomes is uncertain. Swedish investigators assessed 1048 consecutive patients (median age, 65) who were referred to two regional medical centers for evaluation of adrenal incidentalomas to determine risk for death or other adverse outcomes based on levels of autonomous cortisol secretion after a 1-mg dexamethasone suppression test. Median follow-up was 6 years.
Patients whose cortisol levels were in the moderate-high range (83–137 nmol/L [3–5 µg/dL]) or high range (≥138 nmol/L [≥5 µg/dL]) after dexamethasone suppression had significantly higher …