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Adrenalectomy Versus Follow-up in Patients With Subclinical Cushings Syndrome (AUSC)

This study is currently recruiting participants.
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Verified April 2017 by Region Skane
Information provided by (Responsible Party):
Region Skane Identifier:
First received: November 18, 2010
Last updated: April 11, 2017
Last verified: April 2017

Incidental findings of adrenal tumours,"incidentalomas", occur in 1-5 % in the general population and 10-25 % of these patients will exhibit biochemical mild hypercortisolism. Although the patients do not have clinical signs of classical Cushing's syndrome, they have an increased risk for hypertension, dyslipidemia, diabetes mellitus, osteoporosis and obesity.

The hypothesis of the study is, that surgery of the adrenal adenoma responsible for the increased secretion of cortisol, will in part cure or ameliorate the metabolic syndrome.

Condition Intervention
Adrenal Tumour With Mild Hypercortisolism Procedure: Adrenalectomy

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Adrenalectomy Versus Follow-up in Patients With Mild Hypercortisolism: a Prospective Randomized Controlled Trial

Resource links provided by NLM:

Further study details as provided by Region Skane:

Primary Outcome Measures:
  • Normalization of hypertension [ Time Frame: At two years after intervention ]
    Normalization of hypertension according to classification of the World Health Organization (WHO) assessed by 24 hours blood pressure measurement.

Secondary Outcome Measures:
  • Normalization of diabetes mellitus [ Time Frame: At two years after intervention ]
    Normalization of diabetes mellitus according to the criteria of the WHO and assessed by oral glucose tolerance test

  • Decreased body mass index (BMI) to < 30 [ Time Frame: At two years post intervention ]
    Standard assessment of BMI

  • Bone density [ Time Frame: At two years post intervention ]
    Bone density assessed with dual energy x-ray absorptiometry (DEXA) at the lumbar spine and hip

  • Blood lipids [ Time Frame: At two years post intervention ]
    Triglyceride and cholesterol changes of whole serum and of the lipoprotein classes; low-density-lipoprotein (LDL), very-low-density-lipoprotein (VLDL) and high-density-lipoprotein (HDL)

  • Cardiac function [ Time Frame: At two years post intervention ]
    Cardiac function assessed by echocardiography; left ventricular ejection fraction (EF), left ventricular end-diastolic diameter (LVDD), left ventricular mass index (LVMI), ratio between mitral peak velocity flow of the early filling wave and the atrial wave (E/A ratio)

  • Cognitive function [ Time Frame: At two years after intervention ]
    Mini Mental State Examination (MMSE) for cognitive function

  • Quality of Life [ Time Frame: At two years after intervention ]
    Quality of Life assessed by the generic instrument short form 36 (SF-36).

  • Atherosclerosis [ Time Frame: At one and two years after intervention ]

    Carotid ultrasound/duplex scans with evaluation of intimal thickness and plaques.

    Blood pressure measurement for ankle index

Estimated Enrollment: 60
Study Start Date: June 2011
Estimated Study Completion Date: December 2018
Estimated Primary Completion Date: December 2018 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: Follow-up
Patients who are diagnosed with biochemically mild hypercortisolism (so-called subclinical Cushing´s syndrome), who are followed only.
Experimental: Surgery
Patients diagnosed with adrenal tumour and with biochemically mild hypercortisolism (so-called subclinical Cushing´s syndrome), operated with adrenalectomy
Procedure: Adrenalectomy
Adrenalectomy (open or laparoscopic)


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Adrenal tumour with biochemical mild hypercortisolism defined as pathological dexamethasone suppression test (cortisol > 50 nmol/L at 8.00 am after 1 mg dexamethasone at 10 pm, plus one of the following criteria

    • Low or suppressed adrenocorticotropic hormone (ACTH)
    • Low or suppressed dehydroepiandrosterone (DHEA)
    • No or pathological circadian rhythm of cortisol

Exclusion Criteria:

  • Increased levels of 24 hours urinary excretion of cortisol
  • Pregnancy or lactation
  • Inability to understand information or to comply with scheduled follow-up
  • Mild hypercortisolism with bilateral adrenal tumours, without a gradient (lateralization on venous sampling)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01246739

Contact: Anders OJ Bergenfelz, MD, PhD +4646172086
Contact: Erik Nordenström, MD, PhD +4646172305

Skåne University Hospital-Lund, Department of Surgery Recruiting
Lund, Sweden, 22185
Sub-Investigator: Erik Nordenström, MD, PhD         
Sub-Investigator: Martin Almqvist, MD, PhD         
Sponsors and Collaborators
Region Skane
Principal Investigator: Anders OJ Bergenfelz, MD, PhD Department of Surgery, Skåne University Hospital, Lund, Sweden
  More Information

Responsible Party: Region Skane Identifier: NCT01246739     History of Changes
Other Study ID Numbers: 2010/297
Study First Received: November 18, 2010
Last Updated: April 11, 2017

Keywords provided by Region Skane:
mild hypercortisolism
adrenal tumour
surgical procedures, elective

Additional relevant MeSH terms:
Adrenal Gland Neoplasms
Cushing Syndrome
Adrenocortical Hyperfunction
Endocrine Gland Neoplasms
Neoplasms by Site
Adrenal Gland Diseases
Endocrine System Diseases processed this record on September 19, 2017