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Glucose metabolism in patients with subclinical Cushing's syndrome.
[adrenal incidentaloma]
This
clinical
review
will
summarize
the
available
data
regarding
the
effect
of
either
physiological
or
increased
glucocorticoid
concentrations
on
glucose
metabolism
and
insulin
-sensitivity
,
in
order
to
clarify
the
role
,
if
any
,
of
subclinical
Cushing
's
syndrome
(
SCS
)
,
a
status
of
altered
hypothalamic
-
pituitary
-
adrenal
axis
secretion
in
the
absence
of
the
classical
signs
or
symptoms
of
overt
cortisol
excess
,
in
patients
with
adrenal
incidentalomas
(
AI
)
and
diabetes
mellitus
type
2
.
Focusing
on
patients
with
SCS
associated
to
AI
,
while
there
is
convincing
evidence
in
the
literature
that
even
a
mild
hyper
cortisolemia
is
associated
with
alterations
of
glucose
metabolism
,
evidence
is
insufficient
to
conclude
that
the
simple
correction
of
chronic
,
even
mild
,
hypercortisolism
can
completely
revert
metabolic
,
mainly
glycemic
alterations
.
At
the
same
time
,
considering
the
variability
of
the
prevalence
of
Cushing
's
syndrome
in
patients
with
diabetes
mellitus
type
2
reported
in
the
literature
,
no
agreement
does
exist
whether
screening
for
CS
can
be
useful
and
recommended
in
those
patients
.
Diseases
Validation
Diseases presenting
"mild hyper cortisolemia"
symptom
adrenal incidentaloma
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