{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:50:36Z","timestamp":1791669036967,"version":"4.3.4"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Endocrine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>: Non-functioning adrenal incidentalomas (NFAI) are defined by 1\u00a0mg-dexamethasone suppression test (F-1mgDST) cortisol levels\u2009&lt;\u20091.8\u00a0\u00b5g\/dL. However, many individuals with NFAI may exhibit subtle hypercortisolism associated with increased cardiometabolic and skeletal risk. The aims of the present study are to compare F-1mgDST distributions between individuals with NFAI and population-based controls and to explore whether alternative F-1mgDST thresholds would meaningfully modify patient classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a pooled individual participant data analysis of 7 studies evaluating cortisol secretion in patients with type 2 diabetes, osteoporosis and\/or fragility fractures, hypertension, or adrenal incidentalomas. The study included 1681 participants (915 NFAI, 766 controls) with F-1mgDST\u2009&lt;\u20091.8\u00a0\u00b5g\/dL. Data included age, sex, body mass index (BMI), F-1mgDST, and adrenocorticotroph hormone (ACTH). We assessed the between-group differences in F-1mgDST and ACTH and the accuracy of different F-1mgDST thresholds for identifying NFAI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to controls, patients with NFAI had lower age and ACTH levels (62.1\u2009\u00b1\u20099.8 and 59.8\u2009\u00b1\u200912.0 years, 25.1\u2009\u00b1\u200914.1 pg\/mL and 16.3\u2009\u00b1\u200910.4, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for all comparisons), but higher BMI and F-1mgDST values (28.1\u2009\u00b1\u20094.9 and 29.0\u2009\u00b1\u20095.0\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 1.04\u2009\u00b1\u20090.37\u00a0\u00b5g\/dL and 1.13\u2009\u00b1\u20090.39\u00a0\u00b5g\/dL, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for all comparisons) and were more less frequently females (48.0% and 38.6%, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A propensity score analysis performed on 730 patients and 730 age-, BMI- and gender-matched controls confirmed these findings. We did not identify any F-1mgDST threshold with an accuracy exceeding 60% for distinguishing controls from patients with NFAI. The F-1mgDST threshold the best balance between sensitivity (54.8%) and specificity (57.2%) was set at 1.1\u00a0\u00b5g\/dL (30 nmol\/L), although with a low accuracy of 55.8%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individuals with NFAI have higher F-1mgDST levels than controls. More than 40% overlap exists in F-1mgDST values between NFAI and controls.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12020-026-04832-z","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:40:29Z","timestamp":1791668429000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-dexamethasone cortisol levels in non-functioning adrenal incidentalomas: a pooled individual participant data analysis"],"prefix":"10.1007","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7594-3300","authenticated-orcid":false,"given":"Iacopo","family":"Chiodini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Favero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Eller-Vainicher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Morelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Palmieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Bancos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Scillitani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,10]]},"reference":[{"issue":"12","key":"4832_CR1","doi-asserted-by":"publisher","first-page":"2929","DOI":"10.1007\/s40618-024-02440-0","volume":"47","author":"V Favero","year":"2024","unstructured":"V. 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Ethical approval details are reported in the original publications. No new participants were recruited or primary data collected for the present pooled analysis.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all participants in the original contributing studies. No new participants were recruited for the present pooled analysis.","order":2,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"IC received consulting fees from Corcept Therapeutics and HRA Pharma.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"344"}}