Introduction: Secretory adrenal tumors sensitive to luteinizing hormone (LH) and/or human chorionic gonadotropin (hCG) are well documented in the literature. LH and hCG share a mutual LH/hCG receptor and a comparable physiological role.
Objective: The aim of our study was to evaluate the response of adrenal steroids (cortisol, aldosterone and dehydroepiandrosterone sulphate (DHEAS)) to exogenous hCG stimulation in menopausal patients with adrenal incidentalomas (AI).
Methods: The study group consisted of 14 patients with AI, average age 60.13±7.28 years, average BMI 27.60±4.66 kg/m2 and average menopause duration 10.86±7.79 years. Based on the cortisol level after 1 mg dexamethasone suppression test (1 mg DST), AI patients were divided in to two groups: 1st - non-functional AI (NAI) and 2nd AI with (possible) autonomous cortisol secretion ((P)ACS). The morning after 1 mg DST all patients received 10.000 IU hCG intramuscularly starting at 08.00AM with cortisol measurements every 30 minutes for 3 hours. Positive cortisol response to hCG was considered as a raise of cortisol for at least 25% of basal cortisol value (0 min).
Results: Eleven patients showed positive cortisol response, 5 with NAI and 6 with (P)ACS. Maximal response in NAI group was 74%, and in (P)ACS group was 186%. The average cortisol response in group with NAI was 44%, whereas it was 98% in group with (P)ACS. Cortisol response in patients with (P)ACS was significantly higher than in patients with NAI (P<0.05). There was no positive response in aldosterone or DHEAS levels.
Conclusion: Our results imply that LH could be a contributing factor to steroidogenesis in menopausal patients with AI.