ArticleEndocrine2020
Cardiovascular and metabolic risk factors in patients with subclinical Cushing.
Article in Endocrine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 38 citations in OpenAlex.
- Inadequately Controlled Type 2 Diabetes and Hypercortisolism: Improved Glycemia With Mifepristone Treatment.Diabetes care · 2025Trial
- How Common Is Hypercortisolism in Patients With Hypertension? Risk Factors, Epidemiology, and Making a Diagnosis.Diabetes, obesity & metabolism · 2026Review
- Is Hypercortisolism Treatable? Which Patients Should Be Treated and How-A Practical Guide for Clinicians.Diabetes, obesity & metabolism · 2026Review
- Resistant hypertension, hyperaldosteronism, and the emerging understanding of hypercortisolism.Current opinion in cardiology · 2026Review
- Adrenal adenomata displaying mild autonomous cortisol secretion: a service evaluation of cardiometabolic profile routinely screened patients.Cardiovascular endocrinology & metabolism · 2026Article
- The Relationship Between Bone Health Status of Post-Menopausal Women with Non-Functional Adrenal Tumours/Mild Autonomous Cortisol Secretion and Their Baseline Morning Adrenocorticotropic Level.Diagnostics (Basel, Switzerland) · 2026Article
- Prevalence of Hypercortisolism in Difficult-to-Control Type 2 Diabetes.Diabetes care · 2025Observational
- Breaking Through Difficult-to-Control T2D: Targeting Hypercortisolism.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2025Article
- Clinical heterogeneity and imaging-driven genetic screening priorities in patients with radiologically suspected primary bilateral macronodular adrenal hyperplasia.Endocrine connections · 2025Article
- Hypertension and Cushing's syndrome: hunt for the red flag.Journal of endocrinological investigation · 2025Review
- Randomized trial studying metabolic outcomes and quality of life after adrenalectomy versus conservative management for mild autonomous cortisol secretion.Endocrine connections · 2025Article
- Identification of Endogenous Hypercortisolism and the Effect of Mifepristone Treatment in Patients With Difficult-to-Manage Diabetes: A Case Series.Diabetes spectrum : a publication of the American Diabetes Association · 2025Article
- High LDL Particle and APOB Concentrations in Patients With Adrenal Cortical Adenomas.The Journal of clinical endocrinology and metabolism · 2024Article
- Clinical Evaluation of Adrenal Incidentaloma: The Experience of a Referral Center.Biomedicines · 2024Article
- Mild autonomous cortisol secretion: pathophysiology, comorbidities and management approaches.Nature reviews. Endocrinology · 2024Review
- Diabetes Mellitus in Non-Functioning Adrenal Incidentalomas: Analysis of the Mild Autonomous Cortisol Secretion (MACS) Impact on Glucose Profile.Biomedicines · 2024Review
- Article
- Unveiling the hidden impact: Subclinical hypercortisolism and its subtle influence on bone health.Aging medicine (Milton (N.S.W)) · 2024Review
- Endocrine Disorders and Peripheral Arterial Disease - A Series of Reviews Cushing Syndrome-Cortisol Excess.Current vascular pharmacology · 2024Review
- Bilateral co-secretory lesions presenting with coexisting Cushing syndrome and primary aldosteronism: a case report.BMC endocrine disorders · 2023Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAdrenal incidentalomas (AI) are discovered after work-up unrelated to adrenal gland diseases; up to 30% of AI show subclinical endogenous cortisol excess (SH), frequently associated to hypertension, obesity, metabolic disorders and increased incidence of cardiovascular events (CVEs).
methodsWe analysed 628 AI patients divided into two groups: 471 non-functional adrenal adenoma (NFA) and 157 SH. All patients underwent complete examinations, 24-h ambulatory blood pressure monitoring, biohumoral parameters and vascular damage markers, such as c-IMT and ankle brachial index. After long-term follow-up, we registered newly onset of CVEs such as myocardial infarction (MI), percutaneous stenting and surgical bypass (PTA/CABG), stroke, overall/cardiovascular mortality. Moreover, SH patients underwent to surgical (SSH) or pharmacological treatment (MSH).
resultsSH patients showed higher prevalence of metabolic syndrome, diabetes mellitus, and previous CVEs respect NFA at baseline. After follow-up MSH group showed higher recurrence of major CV events compared with NFA and SSH (RR 2.27 MSH vs NFA for MI; RR 2.30 MSH vs NFA for PTA/CABG; RR 2.41 MSH vs NFA for stroke). In SSH there was a significant reduction of the number of antihypertensive medications needed to reach target blood pressure levels (2.3 ± 1.0 to 1.5 ± 0.4 drugs). None differences were found in SH patients, distinguished in relation to cortisol plasma levels after dexamethasone suppression test (1.8-5 µg/dL, above 5 µg/dL).
conclusionsSH is linked to relevant cardiovascular and metabolic alterations, leading to worsen clinical outcomes. In eligible patients, adrenalectomy is valid and safe option to treat SH, reducing cardiometabolic abnormalities.
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