ReviewJournal of endocrinological investigation2021
Hidden hypercortisolism: a too frequently neglected clinical condition.
Review in Journal of endocrinological investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05255900 (Metabolic, Pressor and Neuropsychological Effects of Metyrapone Treatment in Patients With Hypercortisolism), which is not on this map. Cited by 22 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Metabolic, Pressor and Neuropsychological Effects of Metyrapone Treatment in Patients With Hypercortisolism
Who cites it
22 citing papers in PubMed, 28 citations in OpenAlex.
- Adrenalectomy Improves Blood Pressure and Metabolic Control in Patients With Possible Autonomous Cortisol Secretion: Results of a RCT.Frontiers in endocrinology · 2022Trial
- How Common Is Hypercortisolism in Patients With Type 2 Diabetes? Risk Factors, Epidemiology, and Making a Diagnosis Using a Dexamethasone Suppression Test.Diabetes, obesity & metabolism · 2026Review
- Is Hypercortisolism Treatable? Which Patients Should Be Treated and How-A Practical Guide for Clinicians.Diabetes, obesity & metabolism · 2026Review
- How Common Is Hypercortisolism in Patients With Hypertension? Risk Factors, Epidemiology, and Making a Diagnosis.Diabetes, obesity & metabolism · 2026Review
- Resistant hypertension, hyperaldosteronism, and the emerging understanding of hypercortisolism.Current opinion in cardiology · 2026Review
- Retrospective Study of Clinical Characteristics, Natural History and Predictive Factors for Mild Autonomous Cortisol Secretion (MACS) in Patients with Adrenal Incidentalomas in Malaysia.Journal of the ASEAN Federation of Endocrine Societies · 2026Article
- Investigating Endogenous Hypercortisolism Prevalence in a U.S. Population With Resistant Hypertension: MOMENTUM Rationale and Design.JACC. Advances · 2026Article
- Hypertension and Cushing's syndrome: hunt for the red flag.Journal of endocrinological investigation · 2025Review
- Who and how to screen for endogenous hypercortisolism in adrenal and pituitary incidentaloma.Journal of endocrinological investigation · 2025Review
- Diagnostic dilemma in Cushing's syndrome: discrepancy between patient-reported and physician-assessed manifestations.Endocrine · 2024Article
- Gonadal dysfunction in women with diabetes mellitus.Endocrine · 2024Review
- Diabetes Mellitus in Non-Functioning Adrenal Incidentalomas: Analysis of the Mild Autonomous Cortisol Secretion (MACS) Impact on Glucose Profile.Biomedicines · 2024Review
- Article
- Femoral bone mineral density at the time of hip fracture is higher in women with versus without type 2 diabetes mellitus: a cross-sectional study.Journal of endocrinological investigation · 2024Article
- Genotype-negative multiple endocrine neoplasia type 1 with prolactinoma, hyperparathyroidism, and subclinical Cushing's syndrome accompanied by hyperglycemia: a case report.Frontiers in endocrinology · 2024Article
- Recognition of Nonneoplastic Hypercortisolism in the Evaluation of Patients With Cushing Syndrome.Journal of the Endocrine Society · 2023Article
- New perspectives in functional hypogonadotropic hypogonadism: beyond late onset hypogonadism.Frontiers in endocrinology · 2023Review
- Unmet needs in Cushing's syndrome: the patients' perspective.Endocrine connections · 2022Article
- Pathophysiology of Mild Hypercortisolism: From the Bench to the Bedside.International journal of molecular sciences · 2022Review
- Sex Differences in Hypercortisolism and Glucose-Metabolism Disturbances in Patients with Mild Autonomous Cortisol Secretion: Findings From a Single Center in China.Frontiers in endocrinology · 2022Article
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeClassic Cushing's syndrome (CS) is a severe disease characterized by central obesity, hypertension, easy bruising, striae rubrae, buffalo hump, proximal myopathy and hypertricosis. However, several CS cases have also been reported with unusual or camouflaged manifestations. In recent years, several authors investigated the prevalence of "hidden hypercortisolism" (HidHyCo) among subjects affected with bone fragility, hypertension and type 2 diabetes mellitus (DM2). The prevalence of the HidHyCo is estimated to be much higher than that of classic CS. However, similarly to classic CS, HidHyCo is known to increase the risk of fractures, cardiovascular disease and mortality.
methodsWe reviewed all published cases of unusual presentations of hypercortisolism and studies specifically assessing the HidHyCo prevalence in diabetic, osteoporotic and hypertensive patients.
resultsWe found 49 HidHyCo cases, in whom bone fragility, hypertension and diabetes were the presenting manifestations of an otherwise silent hypercortisolism. Amongst these cases, 34.7%, 32.7%, 6.1% and 19.0%, respectively, had bone fragility, hypertension, DM2 or hypertension plus DM2 as the sole clinical manifestations of HidHyCo. Overall, 25% of HidHyCo cases were of pituitary origin, and bone fragility was the very prevalent first manifestation among them. In population studies, it is possible to estimate that 1-4% of patients with apparent primary osteoporosis has a HidHyCo and the prevalence of this condition among diabetics ranges between 3.4 and 10%.
conclusionThese data indicate that patients with resistant or suddenly worsening hypertension or DM2 or unexplainable bone fragility should be screened for HidHyCo using the most recently approved sensitive cut-offs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.