[Surgical excision of subclinical cortisol secreting incidentalomas: Impact on blood pressure, BMI and glucose metabolism].
OBJECTIVE
To compare clinical, vascular and metabolic parameters before and after surgery in patients with subclinical cortisol secreting incidentalomas.


METHODS
Eight patients were investigated before and 12 months after removal of the mass on hemodynamic (blood pressure by MAPA procedure), anthropometric (body weight, body mass index), and metabolic parameters (glucose level, HbA(1c)).


RESULTS
In the whole group, 75% of patients displayed decrease in blood pressure (cessation of at least one hypotensive medication) and 33% of them were definitely cured of hypertension. Seventy-one percent of patients lost body weight and 37.5% lost more than 5%. In the whole group of patients, glucose level decreased by 1.1% and medical treatment was discontinuated in two of three diabetic patients.


CONCLUSIONS
Subclinical cortisol secreting adrenal incidentalomas are associated with cardiovascular risk factors that may be corrected after removal of the mass. Therefore, surgery may be an appropriate choice in patients with subclinical Cushing's syndrome to improve hypertension, body weight and impaired glucose level. Controlled studies comparing surgical treatment to a medical follow-up including optimal cardiovascular risk factors treatment are needed to define the usefulness of surgery in hypertensive patients with subclinical cortisol secreting incidentalomas.
Mauclère-Denost
S
S
Service d'endocrinologie-diabète et maladies métaboliques, USN Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France.
Duron-Martinaud
S
S
Nunes
M -L
M-
Gatta
B
B
Fagour
C
C
Rault
A
A
Gosse
P
P
Tabarin
A
A
D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003480:Cushing Syndrome / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000378:metabolism; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone