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Mild Adrenal Cortisol Excess

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The Hypothalamic-Pituitary-Adrenal Axis in Health and Disease

Abstract

Adrenal subclinical hypercortisolism or mild adrenal cortisol excess has been defined by alterations of the hypothalamic–pituitary–adrenal axis in patients with adrenal adenomas and without overt Cushing syndrome. Mild hypercortisolism is the most common hormonal dysfunction in patients with incidentally diagnosed adrenal masses. Recent reports have linked mild adrenal cortisol excess with several cardiovascular, bone, and metabolic complications, as well as with increased mortality. The pathophysiological mechanisms of mild adrenal cortisol excess are poorly understood, and no consensus exists regarding the appropriate diagnostic criteria of mild adrenal cortisol excess or its management. Existing data have derived predominantly from retrospective or nonrandomized studies. This chapter overviews the most recent progress in the understanding of mild adrenal cortisol excess and highlights remaining gaps to be filled by thoughtfully designed future research.

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Authors and Affiliations

  1. Division of Metabolism, Endocrinology, & Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48109, USA

    Adina F. Turcu & Richard J. Auchus

  2. Department of Pharmacology, University of Michigan, Room 5560A, 1150 West Medical Center Drive, Ann Arbor, MI, 48109, USA

    Richard J. Auchus

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  1. Adina F. Turcu
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  2. Richard J. Auchus
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Correspondence to Richard J. Auchus .

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  1. Division of Endocrinology, Multidisciplinary Pituitary and Skull Base Tumor Center, Memorial Sloan Kettering Cancer Center, New York, New York, USA

    Eliza B. Geer

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Turcu, A.F., Auchus, R.J. (2017). Mild Adrenal Cortisol Excess. In: Geer, E. (eds) The Hypothalamic-Pituitary-Adrenal Axis in Health and Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-45950-9_10

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