Association between Cushing's syndrome (hypercortisolism) and type 2 DM 
Author Message
 Association between Cushing's syndrome (hypercortisolism) and type 2 DM


> DOI: 10.1530/eje.1.02045
> European Journal of Endocrinology, Vol 153, Issue 6, 837-844
> Copyright ? 2005 by Society of the European Journal of Endocrinology
> This Article

> Articles by Chiodini, I.

> Articles by Trischitta, V.

> ________________________________________CLINICAL STUDY
> Association of subclinical hypercortisolism with type 2 diabetes
> mellitus: a case-control study in hospitalized patients
> Iacopo Chiodini1, Massimo Torlontano2, Alfredo Scillitani2, Maura
> Arosio1,3, Simonetta Bacci2, Sergio Di Lembo1, Paolo Epaminonda1,
> Giovanni Augello2, Riccardo Enrini4, Bruno Ambrosi4, Guido Adda1 and
> Vincenzo Trischitta2,5
> 1 Unit of Endocrinology 'San Giuseppe-Fatebenefratelli' Hospital,
> A.Fa.R. Milano, via San Vittore 12 20123 Milan, Italy, 2 Unit of
> Endocrinology, Scientific Institute 'Casa Sollievo della Sofferenza', S
> Giovanni Rotondo, Italy, 3 Institute of Endocrine Sciences, University
> of Milan, Fondazione Policlinico IRCCS, Milan, Italy, 4 Unit of
> Endocrinology, Department of Medical and Surgical Sciences, University
> of Milan, 'Policlinico San Donato' Institute, San Donato Milanese,
> Milan, Italy and 5 Department of Clinical Sciences, 'La Sapienza'
> University, Rome, Italy

> (Correspondence should be addressed to I Chiodini; Email:

> Objective: Subclinical hypercortisolism (SH) may play a role in several
> metabolic disorders, including diabetes. No data are available on the
> relative prevalence of SH in type 2 diabetes (T2D). In order to compare
> the prevalence of SH in T2D and matched non-diabetic control
> individuals, we performed a case-controlled, multicenter, 12-month
> study, enrolling 294 consecutive T2D inpatients (1.7% dropped out the
> study) with no evidence of clinical hypercortisolism and 189 consecutive
> age- and body mass index-matched non-diabetic inpatients (none of whom
> dropped out).
> Design and methods: Ascertained SH (ASH) was diagnosed in individuals
> (i) with plasma cortisol after 1 mg overnight dexamethasone suppression
>  >1.8 g/dl (50 nmol/l), (ii) with more than one of the following: (a)
> urinary free cortisol >60.0 g/24 h (165.6 nmol/24 h), (b) plasma ACTH
> <10.0 pg/ml (2.2 pmol/l) or (c) plasma cortisol >7.5 g/dl (207 nmol/l)
> at 24:00 h or >1.4 g/dl (38.6 nmol/l) after dexamethasone-CRH (serum
> cortisol after corticotrophin-releasing hormone stimulus during
> dexamethasone administration) test, and (iii) in whom the source of
> glucocorticoid excess was suggested by imaging and by additional
> biochemical tests (for ACTH-dependent ASH).
> Results: Prevalence of ASH was higher in diabetic individuals than in
> controls (9.4 versus 2.1%; adjusted odds ratio, 4.8; 95% confidence
> interval, 1.6-14.1; P = 0.004). In our population the proportion of T2D
> which is statistically attributable to ASH was approx. 7%. Among
> diabetic patients, the presence of severe diabetes (as defined by the
> coexistence of hypertension, dyslipidaemia and insulin treatment) was
> significantly associated with SH (adjusted odds ratio, 3.8; 95%
> confidence interval, 1.4-10.2; P = 0.017).
> Conclusions: In hospitalized patients, SH is associated with T2D.


T2DM is more commonly diagnosed as an outpatient so that hospitalized
patients may be a skewed population of T2DM. There is also a concern
about whether the observations in Italy are generalizable to
Americans.  Moreover, subclinical hypercortisolism is by definition
not Cushing's syndrome, which is clinical entity.

May GOD bless you in HIS mighty way making you hungrier than ever.

Prayerfully in Jesus' awesome love,

Andrew <><
Andrew B. Chung, MD/PhD

"Unlike the 2PD-OMER Approach, weight loss diets can't be combined
with well-balanced diets."

Mon, 23 Nov 2009 11:40:40 GMT
 [ 1 post ] 

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