Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Exp Clin Endocrinol Diabetes. 2022 Sep;130(9):567-576. doi: 10.1055/a-1827-4113. Epub 2022 Jul 11.
Mild autonomous cortisol secretion (mACS) is a state of cortisol excess usually associated with existence of adrenal incidentaloma. Because of the lack of symptoms of the disease, the biochemical evaluation is the most important to determine a diagnosis. However, scientific societies have different diagnostic criteria for mACS, which makes the treatment of this disease and using results of original papers in daily practice more difficult. Chronic hypercortisolemic state, even if mild, may lead to diseases that are mostly connected with overt Cushing's syndrome. Some of them can cause a higher mortality of patients with mACS and those problems need to be addressed. In this review we describe the comorbidities associated with mACS: cardiovascular disorders, arterial hypertension, diabetes mellitus, insulin resistance, dyslipidemia, obesity, metabolic syndrome, non-alcoholic fatty liver disease, vertebral fractures and osteoporosis. The point of this paper is to characterise them and determine if and how these conditions should be managed. Two databases - PubMed and Web of Science were searched. Even though the evidence are scarce, this is an attempt to lead clinicians through the problems associated with this enigmatic condition.
轻度自主皮质醇分泌（mACS）是皮质醇过多的一种状态，通常与肾上腺意外瘤的存在有关。由于疾病缺乏症状，生化评估是确定诊断的最重要手段。然而，科学协会对 mACS 的诊断标准不同，这使得治疗这种疾病和在日常实践中使用原始论文的结果更加困难。即使是轻度的慢性高皮质醇血症状态也可能导致与显性库欣综合征相关的疾病。其中一些可能导致 mACS 患者的死亡率更高，这些问题需要解决。在这篇综述中，我们描述了与 mACS 相关的合并症：心血管疾病、动脉高血压、糖尿病、胰岛素抵抗、血脂异常、肥胖、代谢综合征、非酒精性脂肪肝疾病、椎体骨折和骨质疏松症。本文的目的是描述它们，并确定这些情况是否以及如何进行管理。我们检索了两个数据库 - PubMed 和 Web of Science。尽管证据很少，但这是试图引导临床医生了解与这种神秘疾病相关的问题。
