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Subclinical Cushing's syndrome in adrenal incidentalomas--possible metabolic consequences.
[adrenal incidentaloma]
The
presence
of
subclinical
Cushing
's
syndrome
(
SCS
)
and
some
features
of
the
metabolic
syndrome
were
evaluated
in
adrenal
incidentaloma
patients
.
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
.
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
.
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
.
Diseases
Validation
Diseases presenting
"blood pressure"
symptom
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
cadasil
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
fabry disease
familial mediterranean fever
lymphangioleiomyomatosis
pendred syndrome
proteus syndrome
scrub typhus
systemic capillary leak syndrome
thoracic outlet syndrome
typhoid
von hippel-lindau disease
werner syndrome
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