Recent Advances on Subclinical Hypercortisolism

Guido Zavatta; Guido Di Dalmazi

doi:10.1016/j.ecl.2018.01.003

Recent Advances on Subclinical Hypercortisolism

Endocrinol Metab Clin North Am. 2018 Jun;47(2):375-383. doi: 10.1016/j.ecl.2018.01.003. Epub 2018 Apr 9.

Authors

Guido Zavatta¹, Guido Di Dalmazi²

Affiliations

¹ Division of Endocrinology, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, S. Orsola-Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy.
² Division of Endocrinology, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, S. Orsola-Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy. Electronic address: guido.didalmazi@unibo.it.

PMID: 29754638
DOI: 10.1016/j.ecl.2018.01.003

Abstract

During the last 20 years, a significant body of literature has accumulated regarding subclinical hypercortisolism in patients with adrenal incidentalomas. Retrospective studies have indicated these patients have an increase in cardiovascular events and mortality. Current recommendations for patients with adrenal incidentalomas include an overnight low-dose dexamethasone suppression test and a thorough evaluation of cardiovascular and metabolic risk factors. Further hormonal testing and close monitoring are necessary in patients with incomplete suppression. Unilateral adrenalectomy may be beneficial in cases with abnormal suppression and comorbidities related to hypercortisolemia. Prospective studies are need for a better risk stratification and tailored therapy.

Keywords: Adrenal; Cushing’s; Hypercortisolism; Mild; Subclinical.

Publication types

Review

MeSH terms

Adrenalectomy / methods*
Cushing Syndrome / diagnosis*
Cushing Syndrome / metabolism
Cushing Syndrome / therapy
Humans