{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:15:12Z","timestamp":1789985712696,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To identify alterations in steroid metabolism in patients with nonfunctioning adrenal incidentalomas (NFAIs) through the analysis of their urinary steroid profile (USP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional study with one study group (NFAIs, cortisol post dexamethasone suppression test [DST]\u2009\u2264\u20091.8\u2009\u00b5g\/dl [49.7\u2009nmol\/L]) and 2 control groups: patients with autonomous cortisol secretion (ACS group, cortisol post\u2010DST\u2009&gt;\u20091.8\u2009\u00b5g\/dl (49.7\u2009nmol\/L) and patients without adrenal tumours (healthy\u2010adrenal group). Twenty\u2010four\u2010hour\u00a0urine collections for USP measurement (total and free fraction of 51 24\u2009h\u2010urine specimens) were obtained from 73 participants (24 with NFAIs, 24 without AIs, and 25 with ACS). USP was determined by gas chromatography coupled to mass spectrometry. Patients of the three groups were matched according to sex, age (\u00b15 years\u2010old) and body mass index (\u00b15\u2009kg\/m<jats:sup>2<\/jats:sup>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to healthy\u2010adrenal controls, patients with NFAIs had a lower excretion of androgen metabolites (230.5\u2009\u00b1\u2009190.12 vs. 388.7\u2009\u00b1\u2009328.58\u2009\u00b5g\/24\u2009h, <jats:italic>p<\/jats:italic>\u2009=\u2009.046) and a higher excretion of urinary free cortisol (UFC) (54.3\u2009\u00b1\u200966.07 vs. 25.4\u2009\u00b1\u200911.16\u2009\u00b5g\/24\u2009h, <jats:italic>p<\/jats:italic>\u2009=\u2009.038). UFC was above the reference range in 20.8% of patients in the NFAI, compared to 0% in the healthy\u2010adrenal group (<jats:italic>p<\/jats:italic>\u2009=\u2009.018). Patients with ACS had a higher prevalence of hypertension, dyslipidemia, and diabetes than patients with NFAIs or the control group. A lower excretion of androgen metabolites (218.4\u2009\u00b1\u2009204.24 vs. 231\u2009\u00b1\u2009190\u2009\u00b5g\/24\u2009h, <jats:italic>p<\/jats:italic>\u2009=\u2009.041) and a nonsignificant higher excretion of glucocorticoid metabolites (2129.6\u2009\u00b1\u20091195.96 vs. 1550.8\u2009\u00b1\u2009810.03\u2009\u00b5g\/24\u2009h, <jats:italic>p<\/jats:italic>\u2009=\u2009.180) was found in patients with ACS compared to patients with NFAIs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>NFAIs seem to secrete a subtle, yet clinically relevant, excess of glucocorticoids. Future studies are needed to confirm our findings; and to identify metabolic alterations associated with an increased cardiometabolic risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14811","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T02:34:02Z","timestamp":1660703642000},"page":"165-176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Characterisation of the urinary steroid profile of patients with nonfunctioning adrenal incidentalomas: A matched controlled cross\u2010sectional study"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0519-0072","authenticated-orcid":false,"given":"Marta","family":"Araujo\u2010Castro","sequence":"first","affiliation":[{"name":"Department of Endocrinology &amp; Nutrition Ram\u00f3n y Cajal University Hospital Madrid Spain"},{"name":"Fundaci\u00f3n para la Investigaci\u00f3n Biom\u00e9dica Ram\u00f3n y Cajal IRYCIS\u2010Hospital Ram\u00f3n y Cajal Madrid Spain"},{"name":"Universidad de Alcal\u00e1 Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregori","family":"Casals","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Genetics Hospital Clinic, IDIBAPS Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2399-4023","authenticated-orcid":false,"given":"Felicia A.","family":"Hanzu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology &amp; 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