Department of Research, LAU Medical Center-Rizk Hospital, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon.
Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon.
Endocr Metab Immune Disord Drug Targets. 2024;24(13):1518-1524. doi: 10.2174/0118715303266569231129101847.
A far more common disease than Cushing's syndrome is subclinical hypercortisolism or mild autonomous cortisol secretion (MACS), with an overall prevalence of 0.2-2%.
This review aims to shed light on the prevalence, screening and diagnostic criteria, comorbidities, and management of Mild Autonomous Cortisol Secretion (MACS).
Studies eligible targeted MACS regarding prevalence, screening, comorbidities, management, and clinical outcome. This is a narrative-review. IRB approval was not needed.
The 1 mg Dexamethasone suppression test (DST) remains the first screening test. MACS is associated with adverse cardiometabolic and renal outcomes, osteoporosis and osteopenia, immunodeficiency, depression, coagulopathy, and sarcopenia. Surgery is the gold standard treatment. Medical therapy is recommended when surgery is contraindicated or not feasible. Clinically silent hypercortisolism is a frequent entity that necessitates early detection and treatment. The production of cortisol should be looked at as a spectrum where subtle, undetectable levels can still be produced. They know its association with adverse health outcomes.
MACS is no longer considered an asymptomatic disorder; repeated hormonal and functional tests are crucial to prevent multiorgan damage.
库欣综合征远不如亚临床皮质醇增多症或轻度自主皮质醇分泌（MACS）常见，其总体患病率为 0.2-2%。
本综述旨在阐明轻度自主皮质醇分泌（MACS）的患病率、筛查和诊断标准、合并症以及管理。
研究对象为针对 MACS 的患病率、筛查、合并症、管理和临床结局的研究。这是一篇叙述性综述。不需要 IRB 批准。
1mg 地塞米松抑制试验（DST）仍然是首选的筛查试验。MACS 与不良的心血管代谢和肾脏结局、骨质疏松症和骨量减少、免疫功能低下、抑郁、凝血功能障碍和肌肉减少症有关。手术是金标准治疗。当手术禁忌或不可行时，推荐采用药物治疗。临床无症状性皮质醇增多症是一种常见的疾病，需要早期发现和治疗。皮质醇的产生应被视为一个连续谱，即使是微妙的、无法检测到的水平仍可能存在。人们已经认识到它与不良健康结局有关。
MACS 不再被认为是一种无症状疾病；重复的激素和功能测试对于预防多器官损伤至关重要。
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