Effect of single doses of dexamethasone and adrenocorticotrop hormone on serum bone markers in healthy subjects and in patients with adrenal incidentalomas and Cushing’s syndrome

2004 ◽  
Vol 27 (8) ◽  
pp. 747-753 ◽  
Author(s):  
J. Majnik ◽  
N. Szücs ◽  
A. Patócs ◽  
M. Tóth ◽  
K. Balogh ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Healthy Subjects ◽  
Bone Markers ◽  
Cushing's Syndrome ◽  
Adrenal Incidentalomas

Long-term morphological, hormonal, and clinical follow-up in a single unit on 118 patients with adrenal incidentalomas

2010 ◽  
Vol 162 (4) ◽  
pp. 779-785 ◽  
Author(s):  
R Giordano ◽  
E Marinazzo ◽  
R Berardelli ◽  
A Picu ◽  
M Maccario ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Cumulative Risk ◽  
Cushing's Syndrome ◽  
Endocrine Function ◽  
Adrenal Incidentalomas ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Significant Clinical Improvement

ObjectiveTo evaluate long-term morphological, functional, and clinical outcome in adrenal incidentalomas.Design and methodsA total of 118 patients (77 F and 47 M; age 62.3±1.0 years) with adrenal incidentalomas were evaluated at baseline and followed-up for median 3 years (range 1–10 years) by clinical, biochemical, hormonal, and morphological evaluation. Among them, six patients with diagnosis of subclinical Cushing's syndrome (SCS) underwent surgery.ResultsAt entry, 86% (n=102) of tumors were nonfunctioning (NF) and 14% (n=16) showed SCS. Comparing NF with SCS patients, a significantly higher percentage of dyslipidemia was found in the group of SCS patients (50 vs 23%,P=0.033). During follow-up, adrenal function remained normal in all NF patients, none of them developed subclinical or overt endocrine disease. The cumulative risk of mass enlargement was globally low (25%), but progressive up to 8 years. SCS was confirmed in all patients, and none of them shifted to overt Cushing's syndrome. The cumulative risk of developing metabolic–cardiovascular abnormalities was globally low (22%), but progressive up to 8 years and new diseases were recorded in the group of NF patients only (three patients with dyslipidemia, four with impaired fasting glucose/impaired glucose tolerance, and three with diabetes mellitus). SCS patients who underwent surgery did not show any significant clinical improvement.ConclusionsThe risk of mass enlargement, hormonal, and metabolic impairment over time is globally low. Conservative management seems to be appropriate, but further prospective studies are needed to establish the long-term outcome of such patients, especially for metabolic status, cardiovascular risk profile and their relationship with endocrine function.

Subclinical Cushing’s Syndrome in women with adrenal incidentalomas is associated with adipose tissue dysfunction

2016 ◽  
Vol 62 (5) ◽  
pp. 72-73
Author(s):  
Stavroula A. Paschou ◽  
Markella Nezi ◽  
Fotini Dimitropoulou ◽  
Dimitrios Ioannidis ◽  
Argyro Panagiotakou ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Cushing’S Syndrome ◽  
Clinical Signs ◽  
Cushing's Syndrome ◽  
Visceral Adiposity Index ◽  
Adrenal Incidentalomas ◽  
Subclinical Cushing’S Syndrome ◽  
Adipose Tissue Dysfunction ◽  
Mass Size ◽  
And Function

Introduction. The visceral adiposity index (VAI) is a mathematical formula based on simple anthropometric and biochemical parameters and reflects the distribution and function of the adipose tissue.Aim: to investigate the possible association between the presence of subclinical Cushing’s syndrome (SCS) and VAI in patients with adrenal incidentalomas.Patients and methods. We studied 258 patients with adrenal incidentalomas. The diagnosis of SCS was based on a post-LDDST cortisol level ≥1.8 mg/dl combined with an abnormal result of at least one other test of the HPA axis, in the absence of clinical signs. The VAI index was calculated as following: Women VAI= [WC/36.58+(1.89×BMI)] ×(TG/0.81)×(1.52/HDL), Men VAI= [WC/39.68+(1.88×BMI)] ×(TG/1.03)×(1.31/HDL).Results. 122 patients were excluded from the analysis due to overt metabolic problems (8 with BMI>39, 82 with metabolic syndrome and 34 with type 2 diabetes). Among 136 patients who were included in the analysis (42M/94W, 56.9±9.7 y), SCS was diagnosed in 24 (17.6%). Patients with SCS presented with significantly higher levels of insulin (12.4±4.6 vs 9.9±3.2 μIU/ml, p=0.036) and triglycerides (114±36 vs 97±34 mg/dl, p=0.023), larger size of tumors (3.26±0.88 vs 2.28±1.06 cm, p<0.001) and higher calculated VAI (1.77±0.83 vs 1.39±0.69, p=0.045). Regression analysis revealed that the presence of SCS was positively associated with VAI [OR (95% CI) 1.888 (1.051–3.394), p=0.034] but when gender subgroup analysis followed, this was shown only in women [OR (95% CI) 2.284 (1.135–4.595), p=0.021]. Another important prognostic factor for the probability of SCS was the mass size [OR (95% CI) 2.237 (1.441–3.472), p<0.001].Conclusion. SCS in women with adrenal incidentalomas is associated with adipose tissue dysfunction.

Preclinical Cushing's syndrome in adrenal "incidentalomas": comparison with adrenal Cushing's syndrome.

1992 ◽  
Vol 75 (3) ◽  
pp. 826-832 ◽  
Author(s):  
M Reincke ◽  
J Nieke ◽  
G P Krestin ◽  
W Saeger ◽  
B Allolio ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Adrenal Incidentalomas

Adrenal incidentalomas showing unilateral concordant visualization by adrenocortical scintigraphy: Comparison with adenomas in Cushing’s syndrome

2000 ◽  
Vol 14 (3) ◽  
pp. 205-212 ◽  
Author(s):  
Atsushi Tani ◽  
Masayuki Nakajo ◽  
Shinsaku Tsuchimochi ◽  
Yoshiaki Nakabeppu ◽  
Tomokazu Umanodan
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Adrenal Incidentalomas ◽  
Adrenocortical Scintigraphy

scholarly journals Performance of salivary cortisol in the diagnosis of Cushing's syndrome, adrenal incidentaloma, and adrenal insufficiency

2013 ◽  
Vol 169 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Filippo Ceccato ◽  
Mattia Barbot ◽  
Marialuisa Zilio ◽  
Sergio Ferasin ◽  
Gianluca Occhi ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Hpa Axis ◽  
Cushing’S Syndrome ◽  
Salivary Cortisol ◽  
Healthy Subjects ◽  
Adrenal Incidentaloma ◽  
High Sensitivity ◽  
Cushing's Syndrome ◽  
Late Night ◽  
Late Night Salivary Cortisol

ObjectiveSalivary cortisol has recently been suggested for studies on the hypothalamic–pituitary–adrenal (HPA) axis. The lack of circadian rhythm is a marker of Cushing's syndrome (CS), and some authors have reported that low salivary cortisol levels may be a marker of adrenal insufficiency. The aim of our study was to define the role of salivary cortisol in specific diagnostic settings of HPA axis disease.Subjects and methodsWe analyzed morning salivary cortisol (MSC) and late-night salivary cortisol (LNSC) levels in 406 subjects: 52 patients with Cushing's disease (CD), 13 with ectopic CS, 17 with adrenal CS, 27 with CD in remission (a mean follow-up of 66±39 months), 45 with adrenal incidentaloma, 73 assessed as having CS and then ruled out for endogenous hypercortisolism, 75 with adrenal insufficiency, and 104 healthy subjects.ResultsA LNSC value above 5.24 ng/ml differentiated CS patients from controls with high sensitivity (96.3%) and specificity (97.1%); we found higher LNSC levels in ectopic CS patients than in CD patients. We found no difference in MSC and LNSC levels between patients with CD in remission and healthy subjects. Both MSC and LNSC levels were higher in patients with adrenal incidentaloma than in healthy controls. A MSC value below 2.65 ng/ml distinguished patients with adrenal insufficiency from controls with high sensitivity (97.1%) and specificity (93.3%).ConclusionsSalivary cortisol is a useful tool to assess endogenous cortisol excess or adrenal insufficiency and to evaluate stable CD in remission.

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