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 "hypertension" symptom

achondroplasia

acute rheumatic fever

adrenal incidentaloma

aniridia

aromatase deficiency

cadasil

child syndrome

cohen syndrome

congenital adrenal hyperplasia

congenital diaphragmatic hernia

cushing syndrome

cystinuria

erdheim-chester disease

erythropoietic protoporphyria

esophageal adenocarcinoma

fabry disease

familial hypocalciuric hypercalcemia

gm1 gangliosidosis

heparin-induced thrombocytopenia

hereditary cerebral hemorrhage with amyloidosis

holt-oram syndrome

homocystinuria without methylmalonic aciduria

hydrocephalus with stenosis of the aqueduct of sylvius

inclusion body myositis

kallmann syndrome

kindler syndrome

lamellar ichthyosis

lymphangioleiomyomatosis

pendred syndrome

primary effusion lymphoma

scrub typhus

severe combined immunodeficiency

sneddon syndrome

typhoid

von hippel-lindau disease

well-differentiated liposarcoma

werner syndrome

x-linked adrenoleukodystrophy

zellweger syndrome

This symptom has already been validated