Evidence mapPaperPMID 40197221Full record

SynthesisBMC endocrine disorders2025

Metabolic complications and clinical outcomes of non-functioning adrenal incidentalomas: a systematic review and meta-analysis.

Xiaolan Li, Huiyu Lan, Xinying Lin, Huibin Huang, Junping Wen, Gang Chen, Wei Lin

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC endocrine disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Xiaolan Li *Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134 Dongjie Street, Gulou District, Fuzhou, Fujian, China.
Huiyu Lan *Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134 Dongjie Street, Gulou District, Fuzhou, Fujian, China.
Xinying LinDepartment of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134 Dongjie Street, Gulou District, Fuzhou, Fujian, China.
Huibin HuangDepartment of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134 Dongjie Street, Gulou District, Fuzhou, Fujian, China.
Junping WenDepartment of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134 Dongjie Street, Gulou District, Fuzhou, Fujian, China.
Gang ChenDepartment of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134 Dongjie Street, Gulou District, Fuzhou, Fujian, China.
Wei LinDepartment of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134 Dongjie Street, Gulou District, Fuzhou, Fujian, China. caolalin0929@163.com.ORCID http://orcid.org/0000-0002-0455-8752

Funding

Department of Endocrinology (National Clinical Key Specialty) 2023001Fujian Joint Fund for Scientific and Technological Innovation Projects 2023Y9295Fujian Provincial Clinical Research Center for Type 2 Diabetes 2022Y2013Fujian Research and Training Grants for Young and Middle-aged Leaders in Healthcare (2023)417#Natural Science Foundation of Fujian Province 2022J011017
6 · The paper itself

Abstract

backgroundIncreased detection of non-functioning adrenal incidentalomas (NFAI) due to widespread abdominal imaging may underestimate associated metabolic risks. To examine NFAI's impact on metabolic comorbidities and evaluate outcomes in surgical and non-surgical management, including changes in NFAI characteristics during follow-up.

methodsMeta-analysis of studies from PubMed, Embase, Cochrane Library, and Web of Science (January 2000 to May 2024). Studies focusing on patients with serum cortisol levels ≤ 50 nmol/L after 1 mg dexamethasone suppression test (DST). Prevalence of hypertension, diabetes, obesity, and lipid disorders before and after follow-up. Tumor growth (> 10 mm increase) and functional changes (1 mg DST retest) were assessed.

resultsEighteen studies met inclusion criteria (n = 2,059). In the non-surgical group, diabetes (RR: 1.33, 95% CI: 1.07-1.65) and lipid disorders (RR: 1.22, 95% CI: 1.07-1.38) increased significantly, while hypertension (RR: 1.07, 95% CI: 0.99-1.16) and obesity (RR: 1.05, 95% CI: 0.91-1.21) showed no significant change. Surgical intervention significantly improved hypertension (RR: 0.67, 95% CI: 0.52-0.86). During mean follow-up of 46.1 months, 4% (95% CI: 2%- 8%) of NFAI enlarged > 10 mm, while 8% (95% CI: 5%- 14%) became functional during 45.1 months of follow-up.

conclusionsIn patients with NFAI, subtle hormone secretion may exist despite current diagnostic criteria suggesting non-functionality. Such tumors show significant associations with metabolic disorders, particularly diabetes mellitus and dyslipidemia. Future research should focus on developing more sensitive diagnostic methods and establishing evidence-based surgical intervention criteria through prospective studies.

Indexed as

Adrenal Gland NeoplasmsMetabolic DiseasesHumansPrognosisAdrenal incidentaloma (AI)Metabolic comorbiditiesNon-functioning adrenal incidentalomaNon-surgical managementSurgical management

Identifiers

PMID40197221
PMCPMC11974091

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.