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Subclinical Cushing’s syndrome in adrenal incidentalomas
Abstract
This article reviews the available evidence on subclinical Cushing's syndrome in patients who have adrenal incidentalomas. The authors' aim is to present up-to-date information on the most relevant issues of subclinical Cushing's syndrome by addressing the many uncertainties and controversies surrounding this ill-defined endocrine condition.
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“Despite the absence of florid signs and symptoms, ACS in patients AI has been associated with hypertension (215), insulin resistance (216), type 2 diabetes mellitus (217), obesity (218), metabolic syndrome (219), and increased mortality (75).”
From Adrenal incidentaloma (2020) · cites this paper as [215]
In the citing paper
“Focusing on glucose metabolism, the prevalence of IGT or DM has been higher in patients with SCS than in cases of nonfunctioning adenoma or controls (, , , , , , ), but these data were not confirmed by other studies that found much the same prevalence of these comorbidities in SCS as in the overall series of AI and in the general population (, -).”
From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [203]
In the citing paper
“in our and other authors' experience (1), the presence of signs and/or symptoms of cortisol excess is extremely rare in patients referred for the presence of an AI.”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [1]
In the citing paper
“SH is estimated to be present in 5-30% of patients with adrenal masses serendipitously found by imaging for unrelated diseases [adrenal incidentalomas (AI)] (1,5).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [1]
In the citing paper
“Similarly, LDDST has been used to diagnose SH (18,40,41,55) without advantages, with the exception of patients affected with alcoholism, psychiatric disorders, and diabetes in whom this test may be more accurate (1,14,66).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [1]
In the citing paper
“The determination of ACTH levels after CRH does not seem to add any advantage (1,23,34,35,37,38,46) to screening for SH.”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [1]
In the citing paper
“The reason to screen for SH with a higher cutoff than that recommended for overt cortisol excess [1.8 g/dl (50 nmol/liter)] (66) is that in patients without signs or symptoms suggestive of hypercortisolism, the a priori possibility of having SH is estimated to be lower than that of a false-positive result (1).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [1]
In the citing paper
“Therefore, UFC should not be considered an adequate screening test for SH and should be used in combination with other tests or in specific populations (1,14).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [1]
In the citing paper
“Although it may reflect an autonomous ACTH-independent cortisol hypersecretion, available data do not demonstrate that low DHEAS concentration is a reliable index of SH (1,23,35), also considering that DHEAS levels decrease with age (77).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [1]
In the citing paper
“The main pitfall of these studies is that the increased uptake of the radiotracer may simply reflect the presence of enlarged adrenal tissue rather than an increased cortisol secretion (1,35,78).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [1]
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Metadata
- Authors
- Terzolo, M., Bovio, S., Reimondo, G., Pia, A., Osella, G., Borretta, G., & Angeli, A.
- Affiliations
- Ospedale San Luigi Gonzaga (IT)
- Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT)
- Corresponding author
- Terzolo, Massimo
- Venue
- Endocrinology and Metabolism Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2005-06
- Volume
- 34
- Issue
- 2
- Pages
- 423-439
- ISSN
- 0889-8529 (ISSN-L)
- OpenAlex
- W2065618767
- Cited by
- 179
- References
- 100
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 11 · 2022: 4 · 2021: 5 · 2020: 8 · 2019: 5 · 2018: 5 · 2017: 8 · 2016: 10 · 2015: 10 · 2014: 6 · 2013: 10 · 2012: 18
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrinology and Metabolism Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- subclinical Cushing's syndrome, adrenal incidentaloma, adrenocortical hyperfunction, cortisol excess, adrenal adenoma
- MeSH terms
- Adrenal Cortex Neoplasms, Cushing Syndrome, Humans, Incidental Findings
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