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Do the diagnostic criteria for subclinical hypercortisolism exist?

Antoine Tabarin1

  • 1Department of endocrinology, diabetes and nutrition, CHU de Bordeaux, hopital Haut-Lévêque, 33604 Pessac, France.

Annales D'Endocrinologie
|April 18, 2018
PubMed
Summary

Subclinical hypercortisolism (SH) involves mild excess cortisol without overt symptoms. Despite the name, SH may lead to long-term health issues like diabetes and hypertension.

Keywords:
Adrenal incidentalomaAutonomie sécrétaire du cortisolCortisol secretory autonomyDexamethasone suppression testHypercortisolisme infracliniqueHypercortisolisme peu intenseIncidentalome surrénalienMild hypercortisolismSubclinical Cushing's syndromeSubclinical hypercortisolismSyndrome de Cushing infracliniqueTest de freinage par la dexaméthasone

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Area of Science:

  • Endocrinology
  • Metabolic Disorders

Background:

  • Subclinical hypercortisolism (SH) is characterized by mild chronic cortisol excess.
  • Patients with SH lack overt Cushing's syndrome symptoms but may face adverse health outcomes.
  • The terminology surrounding SH is debated, with terms like "subclinical Cushing's syndrome" and "preclinical Cushing syndrome" also used.

Purpose of the Study:

  • To clarify the definition and implications of subclinical hypercortisolism.
  • To discuss the potential long-term health consequences associated with SH.

Main Methods:

  • Review of existing literature and studies on subclinical hypercortisolism.
  • Analysis of the diagnostic criteria and semantic ambiguities related to SH.

Main Results:

  • SH is associated with increased risks of diabetes, hypertension, obesity, and osteoporosis.
  • Current definitions of SH are debated and lack universal consensus.
  • The progression to overt Cushing's syndrome is rare, but non-specific adverse conditions are noted.

Conclusions:

  • Subclinical hypercortisolism, despite lacking overt symptoms, poses significant long-term health risks.
  • Further research is needed to establish clear diagnostic criteria and management strategies for SH.