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Subclinical hypercortisolism: correlation between biochemical diagnostic criteria and clinical aspects.

Abstract：

OBJECTIVE:Subclinical hypercortisolism (SH) has been associated with increased prevalence of hypertension, type 2 diabetes mellitus, dyslipidaemia, central obesity, osteoporosis and vertebral fractures. We aimed to investigate the accuracy of different SH diagnostic criteria in predicting the presence of complications. DESIGN:This was a retrospective study. PATIENTS:We evaluated data from 231 patients (120 women and 111 men) affected with adrenal incidentalomas (AI). MEASUREMENTS:We studied the accuracy of different SH diagnostic criteria (cortisol after 1 mg overnight dexamethasone suppression test - 1mg-DST - at different cut-off such as 49.7, 82.8, 137.9 nmol/l, elevated urinary free cortisol, reduced adrenal corticotroph hormone (ACTH) levels alone or various combination of these parameters) in predicting the concomitant presence of the following three complications: hypertension, type 2 diabetes and vertebral fractures. RESULTS:The criterion characterized by the presence of two of 1mg-DST >82.8 nmol/l, elevated UFC and reduced ACTH struck the best balance between sensitivity and specificity, reaching a good accuracy in predicting the cluster of complications (61.9%; 77.1% and 75.8%, respectively). The presence of this cluster was associated with this criterion (OR 4.75, 95%CI 1.8-12.7, P = 0.002) regardless of gonadal status, body mass index (BMI) and age. CONCLUSIONS:The SH criterion characterized by the presence of two of 1mg-DST >82.8 nmol/l, elevated UFC and reduced ACTH seems the best in predicting the presence of chronic manifestations of subtle cortisol excess.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Morelli V,Masserini B,Salcuni AS,Eller-Vainicher C,Savoca C,Viti R,Coletti F,Guglielmi G,Battista C,Iorio L,Beck-Peccoz P,Ambrosi B,Arosio M,Scillitani A,Chiodini I

doi

10.1111/j.1365-2265.2010.03794.x

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

161-6

issue

2

eissn

0300-0664

issn

1365-2265

pii

CEN3794

journal_volume

73

pub_type

杂志文章,多中心研究

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