{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:49:21Z","timestamp":1783478961256,"version":"3.55.0"},"reference-count":38,"publisher":"The Endocrine Society","issue":"8","funder":[{"name":"Grantov\u00e1 Agentura, Univerzita Karlova (CZ)","award":["160415"],"award-info":[{"award-number":["160415"]}]},{"name":"European Regional Development Fund, ERDF, Praha & EU - Investujeme do va\u0161\u00ed budoucnosti","award":["OPPK CZ.2.16\/3.1.00\/21518"],"award-info":[{"award-number":["OPPK CZ.2.16\/3.1.00\/21518"]}]},{"DOI":"10.13039\/501100003243","name":"Ministerstvo Zdravotnictv\u00ed Cesk\u00e9 Republiky","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003243","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Improvement of imaging methods has led to more incidental adrenal tumor findings, especially adenomas. Routine hormonal evaluation uses only a few steroids to evaluate possible hormonal hypersecretion of these adenomas, but a wide spectrum of serum steroid hormone changes has not been published.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To measure the serum levels of 83 steroids from patients with unilateral and bilateral adrenal incidentalomas to uncover full steroid profile changes in patients with subclinical hypercortisolism (SH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross-sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The study was conducted at a tertiary inpatient clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Fifty-two patients with adrenal incidentalomas (unilateral, n = 29; bilateral, n = 23), including nonfunctioning (n = 11) vs SH (n = 41), and 26 age- and sex-matched controls from the general population were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Eighty-three serum steroids were measured by gas chromatography\u2013tandem mass spectrometry (GC-MS\/MS) before and after 1 mg dexamethasone, ACTH, midnight serum cortisol, and urinary free cortisol\/24 hour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 83 measured steroids, 10 were significantly decreased in patients with SH, including dehydroepiandrosterone sulfate (DHEAS), androsterone sulfate, epiandrosterone sulfate, androstenediol sulfate, conjugated 5\u03b1-androstane-3\u03b2,17\u03b2-diol, and conjugated 5\u03b1-androstane-3\u03b1,17\u03b2-diol. This finding was observed even when unilateral, bilateral, male, and female subgroups were analyzed separately. When we compared routine clinical methods and GC-MS\/MS\u2012measured steroids, the most discriminatory was DHEAS followed by midnight serum cortisol, epiandrosterone sulfate, androsterone sulfate, ACTH, and 16\u03b1-hydroxypregnenolone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SH was associated with decreased levels of adrenal androgens, their metabolites, and pregnenolone metabolite. GC-MS\/MS is a powerful tool for measuring serum levels of these undescribed changes in steroid metabolism, which are characteristic of SH in adrenal incidentalomas.<\/jats:p><\/jats:sec>","DOI":"10.1210\/jc.2018-01926","type":"journal-article","created":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T13:20:36Z","timestamp":1553174436000},"page":"3545-3556","source":"Crossref","is-referenced-by-count":21,"title":["Novel GC-MS\/MS Technique Reveals a Complex Steroid Fingerprint of Subclinical Hypercortisolism in Adrenal Incidentalomas"],"prefix":"10.1210","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0001-9935","authenticated-orcid":false,"suffix":"Jr","given":"V\u00e1clav","family":"H\u00e1na","sequence":"first","affiliation":[{"name":"3rd Department of Internal Medicine, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech 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