The Frequency of Type 2 Diabetic Patients who Meet the Endocrinological Screening Criteria of Subclinical Cushing's Disease

Murakami, Hiroshi; Nigawara, Takeshi; Sakihara, Satoru; Kageyama, Kazunori; Yamashita, Maki; Matsuki, Kota; Tanabe, Jutaro; Matsui, Jun; Tamasawa, Naoki; Suda, Toshio

doi:10.1507/endocrj.k09e-352

Cited by 27 publications

(37 citation statements)

References 21 publications

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“…A lack of characteristic physical findings of Cushing's disease, a loss of circadian rhythmicity of ACTH and cortisol secretion, non-suppressable cortisol by the low-dose dexamethasone suppression test and the response of ACTH to CRH stimulation were all compatible with subclinical Cushing's disease [13,14]. A left adrenal tumor was also detected, nevertheless, the endocrine data were compatible with a diagnosis of subclinical Cushing's disease preoperatively.…”

Section: Declaration Of Conflicts Of Interestsmentioning

confidence: 92%

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A somatotropin-producing pituitary adenoma with an isolated adrenocorticotropin-producing pituitary adenoma in a female patient with acromegaly, subclinical Cushing’s disease and a left adrenal tumor

et al. 2014

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Section: Declaration Of Conflicts Of Interestsmentioning

confidence: 92%

“…Taken together with the clinical findings described above, we made a diagnosis of acromegaly with subclinical Cushing's disease based on the diagnostic criteria published by the Japan Endocrine Society [13,14] and a left adrenal incidentaloma. Transsphenoidal surgery was performed.…”

Section: Case Reportmentioning

confidence: 99%

A somatotropin-producing pituitary adenoma with an isolated adrenocorticotropin-producing pituitary adenoma in a female patient with acromegaly, subclinical Cushing’s disease and a left adrenal tumor

et al. 2014

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“…Included studies were published between 1996 and 2012. Of the 14 studies, 11 were cohort studies (12,13,14,15,16,17,18,19,20,21,22) and three were case-control studies (of which only data on the group with T2D patients were considered) (23,24,25). The 14 study groups contained a total of 2827 T2D patients, none of whom was treated with corticosteroids in any form.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

“…The reported mean age of the patients ranged from 53.5 to 63 years, mean BMI of the patients ranged from 25.0 to 34.5 kg/m 2 , and mean HbA1c ranged from 7.7 to 12.2%. As regards firststep screening, 13 studies used biochemical testing and one study (22) used abdominal CT scan; nine studies were based on inclusion of outpatients, (13,14,15,17,20,21,22,23,24) 4 studies on inpatients (12,16,19,25), and one on both inpatients and outpatients (18).…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Prevalence of hypercortisolism in type 2 diabetes patients: a systematic review and meta-analysis

Steffensen

Pereira

Dekkers

et al. 2016

European Journal of Endocrinology

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Objective: Type 2 diabetes (T2D) and Cushing's syndrome (CS) share clinical characteristics, and several small studies have recorded a high prevalence of hypercortisolism in T2D, which could have therapeutic implications. We aimed to assess the prevalence of endogenous hypercortisolism in T2D patients. Design: Systematic review and meta-analysis of the literature. Methods: A search was performed in SCOPUS, MEDLINE, and EMBASE for original articles assessing the prevalence of endogenous hypercortisolism and CS in T2D. Data were pooled in a random-effect logistic regression model and reported with 95% confidence intervals (95% CI). Results: Fourteen articles were included, with a total of 2827 T2D patients. The pooled prevalence of hypercortisolism and CS was 3.4% (95% CI: 1.5-5.9) and 1.4% (95 CI: 0.4-2.9) respectively. The prevalence did not differ between studies of unselected patients and patients selected based on the presence of metabolic features such as obesity or poor glycemic control (P = 0.41 from meta-regression). Imaging in patients with hypercortisolism (n = 102) revealed adrenal tumors and pituitary tumors in 52 and 14% respectively. Conclusions: Endogenous hypercortisolism is a relatively frequent finding in T2D, which may have therapeutic implications.

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“…Previous studies have shown a prevalence of unsuspected Cushing's syndrome in patients with type 2 diabetes ranging from 0 to 9.4% [14,15]. On the other hand, a prevalence of subclinical Cushing's disease has not been reported.…”

Section: Epidemiology Of Subclinical Cushing's Diseasementioning

confidence: 99%

Pathophysiology and treatment of subclinical Cushing’s disease and pituitary silent corticotroph adenomas [Review]

et al. 2014

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Abstract. Pituitary adrenocorticotropic hormone (ACTH)-secreting tumor presents with a variety of clinical features. We outlined the features of ACTH release and characteristics of corticotroph adenoma cells. We especially focused on the corticotroph adenomas in patients with no clinical features of Cushing's disease. Subclinical Cushing's disease is defined by ACTH-induced mild hypercortisolism without typical features of Cushing's disease. Silent corticotroph adenomas (SCAs) are defined by normal cortisol secretion and ACTH-immunopositive staining without autonomous ACTH secretion. Clinicians who are not well-informed about the disease may sometimes confuse SCAs (because of their clinically silent nature) with "subclinical Cushing's disease". The recent criteria for diagnosing subclinical Cushing's disease in Japan are presented. Cortisol measurement was recently standardized in Japan, so plasma cortisol cutoff level should be reconsidered for the diagnosis. In patients with uncontrolled diabetes and hypertension despite appropriate treatment, subclinical Cushing's disease may be efficiently detected. Subclinical Cushing's disease may be associated with metabolic change. In subclinical Cushing's disease, mild hypercortisolism due to autonomous secretion of ACTH contributes to metabolic change and treatment of subclinical hypercortisolism can reverse this change.

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The Frequency of Type 2 Diabetic Patients who Meet the Endocrinological Screening Criteria of Subclinical Cushing's Disease

Cited by 27 publications

References 21 publications

A somatotropin-producing pituitary adenoma with an isolated adrenocorticotropin-producing pituitary adenoma in a female patient with acromegaly, subclinical Cushing’s disease and a left adrenal tumor

A somatotropin-producing pituitary adenoma with an isolated adrenocorticotropin-producing pituitary adenoma in a female patient with acromegaly, subclinical Cushing’s disease and a left adrenal tumor

DIAGNOSIS OF ENDOCRINE DISEASE: Prevalence of hypercortisolism in type 2 diabetes patients: a systematic review and meta-analysis

Pathophysiology and treatment of subclinical Cushing’s disease and pituitary silent corticotroph adenomas [Review]

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