title: Glucose metabolism in patients with subclinical Cushing's syndrome.
abstract: This clinical review will summarize the available data regarding the effect of either physiological or increased glucocorticoid concentrations on glucose metabolism and insulin-sensitivity, in order to clarify the role, if any, of subclinical Cushing's syndrome (SCS), a status of altered hypothalamic-pituitary-adrenal axis secretion in the absence of the classical signs or symptoms of overt cortisol excess, in patients with adrenal incidentalomas (AI) and diabetes mellitus type 2. Focusing on patients with SCS associated to AI, while there is convincing evidence in the literature that even a mild hyper cortisolemia is associated with alterations of glucose metabolism, evidence is insufficient to conclude that the simple correction of chronic, even mild, hypercortisolism can completely revert metabolic, mainly glycemic alterations. At the same time, considering the variability of the prevalence of Cushing's syndrome in patients with diabetes mellitus type 2 reported in the literature, no agreement does exist whether screening for CS can be useful and recommended in those patients.
authors.affiliation: Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical and Biological Sciences, University of Turin, Corso Dogliotti 14, 10126, Torino, Italy. roberta.giordano@unito.it
authors.forename: Roberta
authors.initials: R
authors.lastname: Giordano
authors.forename: Federica
authors.initials: F
authors.lastname: Guaraldi
authors.forename: Rita
authors.initials: R
authors.lastname: Berardelli
authors.forename: Ioannis
authors.initials: I
authors.lastname: Karamouzis
authors.forename: Valentina
authors.initials: V
authors.lastname: D'Angelo
authors.forename: Elisa
authors.initials: E
authors.lastname: Marinazzo
authors.forename: Andreea
authors.initials: A
authors.lastname: Picu
authors.forename: Ezio
authors.initials: E
authors.lastname: Ghigo
authors.forename: Emanuela
authors.initials: E
authors.lastname: Arvat
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D000315:Adrenalectomy; D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D003480:Cushing Syndrome / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D005938:Glucocorticoids / Q000097:blood / Q000378:metabolism; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007333:Insulin Resistance; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose; D005938:Glucocorticoids; D005947:Glucose