open access

Vol 64, No 3 (2013)
Original papers
Published online: 2013-07-01
Submitted: 2013-07-31
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Subclinical Cushing’s syndrome in adrenal incidentalomas — possible metabolic consequences

Anna Bohdanowicz-Pawlak, Jadwiga Szymczak, Ewa Waszczuk, Marek Bolanowski, Grażyna Bednarek-Tupikowska
Endokrynologia Polska 2013;64(3):186-190.

open access

Vol 64, No 3 (2013)
Original papers
Published online: 2013-07-01
Submitted: 2013-07-31

Abstract


Introduction: The presence of subclinical Cushing’s syndrome (SCS) and some features of the metabolic syndrome were evaluated in adrenal incidentaloma patients.
Material and methods: 165 patients were studied. Plasma cortisol, ACTH, DHEA-S, 17-OH-P, aldosterone, renin activity and 24-h urinary methoxycatecholamines were measured. Fasting concentrations of glucose, insulin, triglycerides, T-chol., HDL-chol. and LDL-chol. were determined and the FIRI and QUICKI indices were calculated. Blood pressure, WHR and BMI were determined in all patients. Forty healthy volunteers were the controls.
Results: 133 patients had unchanged endocrine function, 32 demonstrated hormonal disturbances without clinical symptoms (in 26 nonclinical hypercortisolism). The WHR and blood pressure in the SCS group were significantly higher than in the patients with nonfunctioning adenoma (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 subclinical hyperfunction. 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)

Abstract


Introduction: The presence of subclinical Cushing’s syndrome (SCS) and some features of the metabolic syndrome were evaluated in adrenal incidentaloma patients.
Material and methods: 165 patients were studied. Plasma cortisol, ACTH, DHEA-S, 17-OH-P, aldosterone, renin activity and 24-h urinary methoxycatecholamines were measured. Fasting concentrations of glucose, insulin, triglycerides, T-chol., HDL-chol. and LDL-chol. were determined and the FIRI and QUICKI indices were calculated. Blood pressure, WHR and BMI were determined in all patients. Forty healthy volunteers were the controls.
Results: 133 patients had unchanged endocrine function, 32 demonstrated hormonal disturbances without clinical symptoms (in 26 nonclinical hypercortisolism). The WHR and blood pressure in the SCS group were significantly higher than in the patients with nonfunctioning adenoma (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 subclinical hyperfunction. 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)
Get Citation

Keywords

adrenal incidentaloma; subclinical hypercortisolism; metabolic changes

About this article
Title

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

Journal

Endokrynologia Polska

Issue

Vol 64, No 3 (2013)

Pages

186-190

Published online

2013-07-01

Bibliographic record

Endokrynologia Polska 2013;64(3):186-190.

Keywords

adrenal incidentaloma
subclinical hypercortisolism
metabolic changes

Authors

Anna Bohdanowicz-Pawlak
Jadwiga Szymczak
Ewa Waszczuk
Marek Bolanowski
Grażyna Bednarek-Tupikowska

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