{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:13:46Z","timestamp":1789578826105,"version":"build-2803163510"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Adrenalectomy and conservative management are therapeutic approaches for mild\nautonomous cortisol secretion; however, their comparative clinical impact in\nroutine practice remains uncertain. We aimed to evaluate real-world hormonal,\nclinical, and metabolic outcomes according to the treatment strategy in patients\nwith mild autonomous cortisol secretion. This single-center retrospective\nobservational study included consecutive patients with adrenal incidentaloma\nfulfilling guideline-based diagnostic criteria for mild autonomous cortisol\nsecretion between January 2015 and December 2024. Sixty-five patients with\ncomplete hormonal evaluation and follow-up data were analyzed and classified\ninto surgery (n=23) and conservative (n=42) groups. Demographic\ncharacteristics, adenoma features, comorbidities, hormonal parameters, and\nmetabolic outcomes were assessed at baseline and at the final follow-up. The\nmedian follow-up duration was approximately 3 years and similar between groups\n(p&gt;0.05). At baseline, the body mass index, adenoma size, and\ncortisol levels after the 1-mg dexamethasone suppression test were significantly\nhigher, while adrenocorticotropic hormone levels were lower in the surgery group\n(p=0.02, p=0.02, p=0.036, and p&lt;0.01,\nrespectively). During the follow-up, adrenocorticotropic hormone levels\nincreased and post-dexamethasone suppression test cortisol levels significantly\ndecreased after adrenalectomy (p=0.001 and p=0.036, respectively),\nwhereas metabolic parameters and comorbidity profiles remained largely\nunchanged. In the conservative group, total cholesterol increased modestly over\ntime (p=0.048), with no significant changes in other clinical outcomes.\nNo significant difference in comorbidity progression was observed between\ntreatment strategies. In this real-world cohort, adrenalectomy resulted in clear\nhormonal improvement without parallel short-term metabolic or clinical benefits\ncompared with conservative management. These findings highlight the\nheterogeneous clinical expression of mild autonomous cortisol secretion and\nunderscore the importance of individualized patient selection for surgery.<\/jats:p>","DOI":"10.1055\/a-2830-3972","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T23:40:26Z","timestamp":1774395626000},"page":"260-265","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and Metabolic Outcomes of Adrenalectomy Versus Conservative\nManagement in Mild Autonomous Cortisol Secretion"],"prefix":"10.1055","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0765-0770","authenticated-orcid":false,"given":"Seda","family":"Karsl\u0131","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul,\nTurkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selin","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul,\nTurkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zge","family":"\u015eahin Kimyon","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul,\nTurkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seda","family":"Turgut","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul,\nTurkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husnu","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Health Sciences, Bakirkoy\nDr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0383-6562","authenticated-orcid":false,"given":"Sema","family":"Ciftci","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul,\nTurkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"publisher","first-page":"G1","DOI":"10.1530\/eje-16-0467","article-title":"Management of adrenal incidentalomas: European society of endocrinology clinical\npractice 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Endocrinol"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1530\/EJE-15-0977","article-title":"Adrenalectomy reduces the risk of vertebral fractures in patients with\nmonolateral adrenal incidentalomas and subclinical hypercortisolism","volume":"174","author":"A S Salcuni","year":"2016","journal-title":"Eur J Endocrinol"},{"issue":"06","key":"ref27","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1097\/sla.0000000000006183","article-title":"Adrenalectomy improves body weight, glucose, and blood pressure control in\npatients with mild autonomous cortisol secretion: Results of an randomized\ncontrolled trial by the co-work of adrenal research (COAR) study","volume":"279","author":"J-M Koh","year":"2024","journal-title":"Ann Surg"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1097\/SLA.0b013e31819a47d2","article-title":"Surgical versus conservative management for subclinical cushing syndrome in\nadrenal incidentalomas: A prospective randomized study","volume":"249","author":"A Toniato","year":"2009","journal-title":"Ann Surg"},{"issue":"07","key":"ref29","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/S2213-8587(25)00062-2","article-title":"Surgery for the treatment of arterial hypertension in patients with unilateral\nadrenal incidentalomas and mild autonomous cortisol secretion (CHIRACIC): A\nmulticentre, open-label, superiority randomised controlled trial","volume":"13","author":"A Tabarin","year":"2025","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"08","key":"ref30","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.7326\/M20-7946","article-title":"Association between mortality and levels of autonomous cortisol secretion by\nadrenal incidentalomas: A cohort study","volume":"174","author":"A Kjellbom","year":"2021","journal-title":"Ann Int 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Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2830-3972.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T22:30:29Z","timestamp":1783981829000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2830-3972"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,24]]},"references-count":30,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2026,7,13]]},"published-print":{"date-parts":[[2026,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2830-3972","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,24]]}}}