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Henrik Olsen, Albin Kjellbom, Magnus Löndahl and Ola Lindgren

Objective:

Autonomous cortisol secretion and possible autonomous cortisol secretion (ACS/pACS) are associated to an increase of cardiovascular risk factors such as hypertension, diabetes mellitus and dyslipidaemia. To our knowledge, the prevalence of smoking, another well-established risk factor for cardiovascular disease, has not been studied in detail in people with ACS/pACS or adrenal incidentalomas.

Methods:

Patients with adrenal incidentalomas were examined with the 1-mg overnight dexamethasone suppression test (cortisolONDST). Information about current smoking was collected from the patient’s records.

Results:

We studied 1044 patients, of whom 370 (35%) were current smokers. Of these, 22% had bilateral AI compared to 12% of the non-smokers (P < 0.001). Among patients with unilateral adrenal incidentalomas, smokers had larger adrenal incidentalomas than non-smokers (22 mm vs 19 mm, P < 0.001). Smokers also more often had cortisolONDST ≥50 nmol/L than non-smokers, 54% vs 40% (P < 0.001), a finding independent of the size of the adrenal incidentaloma in patients with unilateral adrenal incidentalomas.

Conclusions:

In the present study of patients with adrenal incidentalomas, the prevalence of current smoking was higher than in the general population. Furthermore, smokers had larger unilateral adrenal incidentalomas, more often bilateral adrenal incidentalomas, and more frequently ACS/pACS. Whether smoking is a risk factor for adrenal incidentalomas and ACS/pACS or our findings are due to case selection needs to be further studied.

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Jesper Rye Andersen, Birgit Borggaard, Erik Schroeder, Elith Bjarne Olsen, Hans Stimpel and Henrik Christian Nyholm

Abstract. Human decidual tissue from uncomplicated term pregnancies was incubated in vitro using a cross-over design of incubation lasting for 72 h. The decidual tissue of each membrane was added sequentially to media with the osmolalities 252, 315 and 387 mmol/kg, and the different osmolalities were in 33 experiments induced by changing the concentration either of sodium chloride, potassium chloride, mannitol, sucrose, or choline chloride.

At 387 mmol/kg all substances elicited a significant increase in Prl secretion compared with the 315 mmol/kg media (14–27%) or the 252 mmol/kg media (26–46%). When the sodium chloride, potassium chloride, sucrose, and choline chloride media at 387 mmol/kg were compared in another 7 experiments, potassium chloride increased Prl secretion more effectively than the others (10%, P < 0.05).

The incubation cross-over design did not permit determination of the decidual Prl content after incubation in each of the various media, but in 28 experiments the mean decidual Prl content was 12.7 mIU per 100 mg dry tissue (range 4–30) before and 8.7 mIU per 100 mg dry tissue (1–17) after the experiments. The mean amount of Prl secreted during the successive incubations was 152.2 mIU per 100 mg dry tissue (19–672) which showed the secretion to be a result of continued Prl production. The effect of osmolality was independent of the basal production rate. These results indicate that the intracellular ionic concentrations, probably of potassium ion or of chloride ion, are of importance in the regulation of the synthesis and secretion of decidual Prl in vitro.