title: Evaluation of the cardiovascular risk in patients with subclinical Cushing syndrome before and after surgery.
abstract: BACKGROUND
  The widespread use of ultrasound, computerized tomography, and magnetic resonance imaging has led to an increase in the number of incidental adrenal masses identified. Asymptomatic incidentally discovered adrenal masses may indicate that subclinical Cushing syndrome (SCS) is not uncommon. We aimed to evaluate the cardiovascular risk of patients with SCS before and after surgery.
  
  
  METHODS
  An autonomous cortisol-producing tumor was detected in 11 of 94 patients with adrenal incidentaloma between 1995 and 2005. Twenty-eight patients suffering from classical Cushing syndrome (CS) associated with unilateral adrenocortical adenoma, who were treated at our department in the same period, served as a control group. Cardiovascular risk factors such as blood pressure, body mass index, and lipid profile were evaluated before and 1 year after surgery.
  
  
  RESULTS
  The frequency of hypertension (61% versus 63%), obesity (46% versus 55%), diabetes mellitus (50% versus 36%), hypercholesterolemia (39% versus 36%), and low HDL cholesterol (28% versus 36%) were not significantly different between CS and SCS patients, respectively. Adverse cardiovascular risk profile improved 1 year after adrenalectomy in both groups, although the changes were not significant with respect to body mass index, frequency of diabetes, and hyperlipidemia in SCS patients. But frequency of systolic/diastolic hypertension decreased significantly in this group.
  
  
  CONCLUSIONS
  These findings indicate that the increased incidence of cardiovascular risk factors commonly observed in classical CS, is also present in SCS. Unilateral adrenalectomy does not always lead to significant improvements in cardiovascular risk profile in SCS.
authors.affiliation: Department of General Surgery, Istanbul University, Istanbul Medical Faculty, 34340 Capa, Istanbul, Turkey. yerbil2003@yahoo.com
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Erbil
authors.forename: Evin
authors.initials: E
authors.lastname: Ademoğlu
authors.forename: Neşe
authors.initials: N
authors.lastname: Ozbey
authors.forename: Umut
authors.initials: U
authors.lastname: Barbaros
authors.forename: Burcu Tulumoğlu
authors.initials: BT
authors.lastname: Yanik
authors.forename: Artur
authors.initials: A
authors.lastname: Salmaslioğlu
authors.forename: Alp
authors.initials: A
authors.lastname: Bozbora
authors.forename: Selçuk
authors.initials: S
authors.lastname: Ozarmağan
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000150:complications; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000150:complications; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000601:surgery*; D015897:Comorbidity; D003480:Cushing Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors