| Subclinical hypercortisolism: correlation between biochemical diagnostic criteria and clinical aspects. | |
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MedLine Citation:
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PMID: 20184600 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Subclinical hypercortisolism (SH) has been associated with increased prevalence of hypertension, type 2 diabetes mellitus, dyslipidaemia, central obesity, osteoporosis and vertebral fractures. We aimed to investigate the accuracy of different SH diagnostic criteria in predicting the presence of complications. DESIGN: This was a retrospective study. PATIENTS: We evaluated data from 231 patients (120 women and 111 men) affected with adrenal incidentalomas (AI). MEASUREMENTS: We studied the accuracy of different SH diagnostic criteria (cortisol after 1 mg overnight dexamethasone suppression test - 1mg-DST - at different cut-off such as 49.7, 82.8, 137.9 nmol/l, elevated urinary free cortisol, reduced adrenal corticotroph hormone (ACTH) levels alone or various combination of these parameters) in predicting the concomitant presence of the following three complications: hypertension, type 2 diabetes and vertebral fractures. RESULTS: The criterion characterized by the presence of two of 1mg-DST >82.8 nmol/l, elevated UFC and reduced ACTH struck the best balance between sensitivity and specificity, reaching a good accuracy in predicting the cluster of complications (61.9%; 77.1% and 75.8%, respectively). The presence of this cluster was associated with this criterion (OR 4.75, 95%CI 1.8-12.7, P = 0.002) regardless of gonadal status, body mass index (BMI) and age. CONCLUSIONS: The SH criterion characterized by the presence of two of 1mg-DST >82.8 nmol/l, elevated UFC and reduced ACTH seems the best in predicting the presence of chronic manifestations of subtle cortisol excess. |
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Authors:
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V Morelli; B Masserini; A S Salcuni; C Eller-Vainicher; C Savoca; R Viti; F Coletti; G Guglielmi; C Battista; L Iorio; P Beck-Peccoz; B Ambrosi; M Arosio; A Scillitani; I Chiodini |
Publication Detail:
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Type: Evaluation Studies; Journal Article; Multicenter Study Date: 2010-02-23 |
Journal Detail:
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Title: Clinical endocrinology Volume: 73 ISSN: 1365-2265 ISO Abbreviation: Clin. Endocrinol. (Oxf) Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-27 Completed Date: 2010-12-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0346653 Medline TA: Clin Endocrinol (Oxf) Country: England |
Other Details:
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Languages: eng Pagination: 161-6 Citation Subset: IM |
Affiliation:
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Unit of Endocrinology and Diabetology, Department of Medical Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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complications,
diagnosis Adrenal Gland Neoplasms / complications, diagnosis Adrenocorticotropic Hormone / analysis, blood Aged Cushing Syndrome / complications, diagnosis*, etiology, pathology Dexamethasone / diagnostic use Female Humans Hydrocortisone / diagnostic use Incidental Findings Male Middle Aged Pituitary-Adrenal Function Tests Predictive Value of Tests Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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50-02-2/Dexamethasone; 50-23-7/Hydrocortisone; 9002-60-2/Adrenocorticotropic Hormone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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