Subclinical Cushing’s syndrome in adrenal incidentalomas — possible metabolic consequences

INTRODUCTION: The presence of subclinical Cushing’s syndrome (SCS) and some features of the metabolic syndrome were evaluated inadrenal incidentaloma patients. MATERIAL AND METHODS: 165 patients were studied. Plasma cortisol, ACTH, DHEA-S, 17-OH-P, aldosterone, renin activity and 24-h urinarymethoxy...

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Published in:Endokrynologia polska 2013-01, Vol.64 (3), p.186-190
Main Authors: Bohdanowicz-Pawlak, Anna, Szymczak, Jadwiga, Waszczuk, Ewa, Bolanowski, Marek, Bednarek-Tupikowska, Grażyna
Format: Article
Language:English
Subjects:
Blood pressure
Cushing syndrome
Insulin
Metabolic syndrome
Triglycerides
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Summary:INTRODUCTION: The presence of subclinical Cushing’s syndrome (SCS) and some features of the metabolic syndrome were evaluated inadrenal incidentaloma patients. MATERIAL AND METHODS: 165 patients were studied. Plasma cortisol, ACTH, DHEA-S, 17-OH-P, aldosterone, renin activity and 24-h urinarymethoxycatecholamines were measured. Fasting concentrations of glucose, insulin, triglycerides, T-chol., HDL-chol. and LDL-chol. weredetermined and the FIRI and QUICKI indices were calculated. Blood pressure, WHR and BMI were determined in all patients. Fortyhealthy volunteers were the controls. RESULTS: 133 patients had unchanged endocrine function, 32 demonstrated hormonal disturbances without clinical symptoms (in 26 nonclinicalhypercortisolism). The WHR and blood pressure in the SCS group were significantly higher than in the patients with nonfunctioningadenoma (NA). T-chol and LDL-chol were significantly higher, but HDL-chol was significantly lower, in the SCS than in the NA patients.Fasting insulin level was significantly higher in the SCS than in the NA patients and controls, while fasting glucose level was comparable.QUICKI was significantly lower in the SCS and NA patients than in the controls, while FIRI was significantly higher in the SCS group. CONCLUSIONS: In incidentaloma patients, hormonal function of the adrenal gland should be estimated because some of them present subclinicalhyperfunction. These patients frequently display features of metabolic syndrome such as insulin resistance, hypertension, high triglycerides,T-chol and LDL-chol levels. Subtle autonomous cortisol secretion may be the cause of these features. (Endokrynol Pol 2013; 64 (3): 186–191)
ISSN:0423-104X