{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:32:50Z","timestamp":1788449570682,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"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":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the clinical, laboratory findings\u00a0and signal intensity index (SII) on magnetic resonance imaging (MRI) of patients with bilateral and unilateral macronodular mild autonomous cortisol secretion (MACS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Measurements<\/jats:title><jats:p>Clinical and laboratory findings of <jats:styled-content>81<\/jats:styled-content>\u00a0patients with MACS were examined from retrospective records. SII of adenomas and internodular areas were evaluated by MRI. The unilateral group included patients with an adrenal macronodule (\u22651\u2009cm) in a single adrenal gland, while the bilateral group included patients with at least one macronodule in both adrenal glands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 46 patients were in the unilateral (57%), while 35 (43%) patients were in the bilateral groups. The dehydroepiandrosterone sulphate\u00a0(DHEA\u2010S) level was lower in the unilateral than in the bilateral group (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The presence of type 2 diabetes mellitus (T2DM), glycosylated haemoglobin (HbA1c) and low\u2010density lipoprotein\u00a0(LDL) concentrations were higher in the bilateral group (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). However, no significant difference was detected in terms of adrenocorticotropic hormone\u00a0(ACTH) and overnight 1\u2009mg\u00a0dexamethasone suppression test (DST) between the two groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). There was no difference in SII between adenomas within the same patient, as well as between the unilateral and bilateral groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). Logistic regression analysis based on the differentiation between unilateral and bilateral macronodular MACS demonstrated that DHEA\u2010S, HbA1c\u00a0and LDL concentrations were associated factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>DHEA\u2010S levels may not be as suppressed in patients with bilateral macronodular MACS as compared to those with unilateral adenoma. T2DM and hypercholesterolaemia have a higher frequency in bilateral patients. However, ACTH, overnight 1\u2009mg\u00a0DST\u00a0and SII may not provide additional information for differentiation of bilaterality and unilaterality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15109","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T21:21:41Z","timestamp":1719523301000},"page":"99-107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Beyond symptomatology: A comparative analysis of unilateral and bilateral macronodular mild autonomous cortisol secretion"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0042-6928","authenticated-orcid":false,"given":"Tugba","family":"Barlas","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism Gazi University, Faculty of Medicine Ankara 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