Endocrine

, Volume 41, Issue 3, pp 415–423

Glucose metabolism in patients with subclinical Cushing’s syndrome

  • Roberta Giordano
  • Federica Guaraldi
  • Rita Berardelli
  • Ioannis Karamouzis
  • Valentina D’Angelo
  • Elisa Marinazzo
  • Andreea Picu
  • Ezio Ghigo
  • Emanuela Arvat
Mini Review

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.

Keywords

Glucose Insulin Diabetes mellitus HPA axis Subclinical Cushing’s syndrome 

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Roberta Giordano
    • 1
  • Federica Guaraldi
    • 2
  • Rita Berardelli
    • 2
  • Ioannis Karamouzis
    • 2
  • Valentina D’Angelo
    • 2
  • Elisa Marinazzo
    • 2
  • Andreea Picu
    • 2
  • Ezio Ghigo
    • 2
  • Emanuela Arvat
    • 2
  1. 1.Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical and Biological SciencesUniversity of TurinTorinoItaly
  2. 2.Division of Endocrinology, Diabetology and Metabolism, Department of Internal MedicineUniversity of TurinTorinoItaly

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