{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:25:15Z","timestamp":1793053515487,"version":"4.5.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>The independent role of mild autonomous cortisol secretion (ACS) in influencing the cardiovascular event (CVE) occurrence is a topic of interest. We investigated the role of mild ACS in the CVE occurrence in patients with adrenal incidentaloma (AI) by standard statistics and artificial neural networks (ANNs).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We analyzed a retrospective record of 518 AI patients. Data regarding cortisol levels after 1\u2009mg dexamethasone suppression (1 mg DST) and the presence of obesity (OB), hypertension (AH), type-2 diabetes (T2DM), dyslipidemia (DL), familial CVE history, smoking habit and CVE were collected.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The receiver-operating characteristic curve analysis suggested that 1 mg DST, at a cut-off of 1.8\u2009\u00b5g\/dL, had the best accuracy for detecting patients with increased CVE risk. In patients with 1\u2009mg-DST \u22651.8\u2009\u00b5g\/dL (DST+, <jats:italic>n<\/jats:italic>\u2009=\u2009223), age and prevalence of AH, T2DM, DL and CVE (66 years, 74.5, 25.9, 41.4 and 26.8% respectively) were higher than that of patients with 1\u2009mg-DST \u22641.8\u2009\u00b5g\/dL (61.9 years, 60.7, 18.5, 32.9 and 10%, respectively, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 for all). The CVE were associated with DST+ (OR: 2.46, 95% CI: 1.5\u20134.1, <jats:italic>P<\/jats:italic>\u2009=\u20090.01), regardless of T2DM, AH, DL, smoking habit, gender, observation period and age. The presence of at least two among AH, T2DM, DL and OB plus DST+ had 61.1% sensitivity in detecting patients with CVE. By using the variables selected by ANNs (familial CVE history, age, T2DM, AH, DL and DST+) 78.7% sensitivity was reached.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Cortisol after 1\u2009mg-DST is independently associated with the CVE occurrence. The ANNs might help for assessing the CVE risk in AI patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1530\/eje-17-0047","type":"journal-article","created":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T00:40:29Z","timestamp":1493858429000},"page":"73-83","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":58,"title":["Cardiovascular events in patients with mild autonomous cortisol secretion: analysis with artificial neural networks"],"prefix":"10.1093","volume":"177","author":[{"given":"Valentina","family":"Morelli","sequence":"first","affiliation":[{"name":"1Department of Medical Sciences and Community HealthUniversity of Milan, Milan, Italy"},{"name":"2Unit of Endocrinology and Metabolic DiseasesIRCCS C\u00e0 Granda-Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Palmieri","sequence":"additional","affiliation":[{"name":"1Department of Medical Sciences and Community HealthUniversity of Milan, Milan, Italy"},{"name":"2Unit of Endocrinology and Metabolic DiseasesIRCCS C\u00e0 Granda-Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lania","sequence":"additional","affiliation":[{"name":"3Endocrine UnitIRCCS Humanitas Clinical Institute, Humanitas University, Rozzano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Tresoldi","sequence":"additional","affiliation":[{"name":"1Department of Medical Sciences and Community HealthUniversity of Milan, Milan, Italy"},{"name":"3Endocrine UnitIRCCS Humanitas Clinical Institute, Humanitas University, Rozzano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Corbetta","sequence":"additional","affiliation":[{"name":"4Department of Biomedical SciencesUnit of Endocrinology, University of Milan, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Cairoli","sequence":"additional","affiliation":[{"name":"1Department of Medical Sciences and Community HealthUniversity of Milan, Milan, Italy"},{"name":"2Unit of Endocrinology and Metabolic DiseasesIRCCS C\u00e0 Granda-Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Eller-Vainicher","sequence":"additional","affiliation":[{"name":"2Unit of Endocrinology and Metabolic DiseasesIRCCS C\u00e0 Granda-Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Arosio","sequence":"additional","affiliation":[{"name":"1Department of Medical Sciences and Community HealthUniversity of Milan, Milan, Italy"},{"name":"2Unit of Endocrinology and Metabolic DiseasesIRCCS C\u00e0 Granda-Ospedale Maggiore Policlinico, Milan, Italy"},{"name":"5Unit of Endocrine Diseases and DiabetologyOspedale San Giuseppe, Gruppo Multimedica, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Copetti","sequence":"additional","affiliation":[{"name":"6Unit of Biostatistics \u2018Casa Sollievo della Sofferenza\u2019IRCCS, San Giovanni Rotondo, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enzo","family":"Grossi","sequence":"additional","affiliation":[{"name":"7Semeion CenterRome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iacopo","family":"Chiodini","sequence":"additional","affiliation":[{"name":"1Department of Medical Sciences and Community HealthUniversity of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2017053117252459000_177.1.73.1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-16-0467"},{"key":"2017053117252459000_177.1.73.2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-2722"},{"key":"2017053117252459000_177.1.73.3","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1097\/MED.0000000000000151","article-title":"Subclinical hypercortisolism in adrenal incidentaloma","volume":"22","author":"Debono","year":"2015","journal-title":"Current Opinion in Endocrinology Diabetes and Obesity"},{"key":"2017053117252459000_177.1.73.4","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ecl.2015.02.009","article-title":"Adrenal mild hypercortisolism","volume":"44","author":"Goddard","year":"2015","journal-title":"Endocrinology Metabolism Clinics of North America"},{"key":"2017053117252459000_177.1.73.5","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-16-0289"},{"key":"2017053117252459000_177.1.73.6","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s12020-012-9628-9","article-title":"Ghigo & Arvat E. 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