CoChat
Sign Up
Cited by 190Adrenal Hormones and DisordersPituitary Gland Disorders and TreatmentsStress Responses and Cortisol

Association of subclinical hypercortisolism with type 2 diabetes mellitus: a case-control study in hospitalized patients

Chiodini, Iacopo, Torlontano, Massimo, Scillitani, Alfredo, Arosio, Maura, Bacci, Simonetta, Di Lembo, Sergio, Epaminonda, Paolo, Augello, Giovanni +4 more·2005·European Journal of Endocrinology
DOI 10.1530/eje.1.02045
Open this paper in CoChat — free account

Abstract

OBJECTIVE: Subclinical hypercortisolism (SH) may play a role in several metabolic disorders, including diabetes. No data are available on the relative prevalence of SH in type 2 diabetes (T2D). In order to compare the prevalence of SH in T2D and matched non-diabetic control individuals, we performed a case-controlled, multicenter, 12-month study, enrolling 294 consecutive T2D inpatients (1.7% dropped out the study) with no evidence of clinical hypercortisolism and 189 consecutive age- and body mass index-matched non-diabetic inpatients (none of whom dropped out). DESIGN AND METHODS: Ascertained SH (ASH) was diagnosed in individuals (i) with plasma cortisol after 1 mg overnight dexamethasone suppression >1.8 microg/dl (50 nmol/l), (ii) with more than one of the following: (a) urinary free cortisol >60.0 microg/24 h (165.6 nmol/24 h), (b) plasma ACTH <10.0 pg/ml (2.2 pmol/l) or (c) plasma cortisol >7.5 microg/dl (207 nmol/l) at 24:00 h or >1.4 microg/dl (38.6 nmol/l) after dexamethasone-CRH (serum cortisol after corticotrophin-releasing hormone stimulus during dexamethasone administration) test, and (iii) in whom the source of glucocorticoid excess was suggested by imaging and by additional biochemical tests (for ACTH-dependent ASH). RESULTS: Prevalence of ASH was higher in diabetic individuals than in controls (9.4 versus 2.1%; adjusted odds ratio, 4.8; 95% confidence interval, 1.6-14.1; P = 0.004). In our population the proportion of T2D which is statistically attributable to ASH was approx. 7%. Among diabetic patients, the presence of severe diabetes (as defined by the coexistence of hypertension, dyslipidaemia and insulin treatment) was significantly associated with SH (adjusted odds ratio, 3.8; 95% confidence interval, 1.4-10.2; P = 0.017). CONCLUSIONS: In hospitalized patients, SH is associated with T2D.

Integrity signals

Registry

Crossref · 10.1530/eje.1.02045

Cites

23 of 23 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The prevalence of previously unsuspected Cushing syndrome in patients with type 2 diabetes ranges from 0% to 9.4%.

    “The association between DM and CS has been examined in various studies, which have shown a prevalence of previously unsuspected CS in patients with type  DM ranging from % to .% (Table ) (-).”

    From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [247]

  • In a controlled study of 294 diabetic inpatients, the prevalence of subclinical hypercortisolism was 10.8%, with pituitary, adrenal, and undefined/ectopic origins accounting for 1.4%, 7.2%, and 2.2%, respectively.

    “These data were confirmed in a similar controlled study on 294 diabetic inpatients in whom a 10.8% prevalence of SH was found, with pituitary, adrenal, and undefined/ectopic origin accounting for 1.4, 7.2, and 2.2%, respectively (83).”

    From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [83]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Chiodini, I., Torlontano, M., Scillitani, A., Arosio, M., Bacci, S., Di Lembo, S., Epaminonda, P., Augello, G., Enrini, R., Ambrosi, B., Adda, G., & Trischitta, V.
Affiliations
  • Casa Sollievo della Sofferenza (IT)
  • University of Milan (IT)
Corresponding author
Chiodini, Iacopo
ORCID
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2005-12
Volume
153
Issue
6
Pages
837-844
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje.1.02045
OpenAlex
W2171330156
Cited by
190
References
23
Citations by year
2026: 6 · 2025: 7 · 2024: 6 · 2023: 8 · 2022: 6 · 2021: 14 · 2020: 8 · 2019: 4 · 2018: 6 · 2017: 10 · 2016: 13 · 2015: 13 · 2014: 8 · 2013: 6 · 2012: 15
FWCI
5.18
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
subclinical hypercortisolism, type 2 diabetes, prevalence, ACTH-dependent Cushing's syndrome, ACTH-independent Cushing's syndrome, dexamethasone suppression test, urinary free cortisol, hospitalized patients, severe diabetes, hypertension, dyslipidemia, insulin therapy, glucocorticoid excess, attributable fraction, metabolic disorders, ACTH, cortisol, Cushing's disease
MeSH terms
Adrenocorticotropic Hormone, Adult, Aged, Aged, 80 and over, Corticotropin-Releasing Hormone, Cushing Syndrome, Dexamethasone, Diabetes Mellitus, Type 2, Female, Humans, Hydrocortisone, Male, Middle Aged, Body Mass Index, Case-Control Studies

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review