Is There Value in Routine Screening for Cushing’s Syndrome in Patients with Diabetes?

Mullan, Karen; Black, Neil; Thiraviaraj, Athinia; Bell, P. M.; Burgess, Colin; Hunter, Steven; McCance, David R.; Leslie, H.; Sheridan, B.; Atkinson, A. B.

doi:10.1210/jc.2009-2453

Cited by 61 publications

(54 citation statements)

References 19 publications

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“…Included studies were published between 1996 and 2012. Of the 14 studies, 11 were cohort studies (12,13,14,15,16,17,18,19,20,21,22) and three were case-control studies (of which only data on the group with T2D patients were considered) (23,24,25). The 14 study groups contained a total of 2827 T2D patients, none of whom was treated with corticosteroids in any form.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

“…The reported mean age of the patients ranged from 53.5 to 63 years, mean BMI of the patients ranged from 25.0 to 34.5 kg/m 2 , and mean HbA1c ranged from 7.7 to 12.2%. As regards firststep screening, 13 studies used biochemical testing and one study (22) used abdominal CT scan; nine studies were based on inclusion of outpatients, (13,14,15,17,20,21,22,23,24) 4 studies on inpatients (12,16,19,25), and one on both inpatients and outpatients (18).…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

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DIAGNOSIS OF ENDOCRINE DISEASE: Prevalence of hypercortisolism in type 2 diabetes patients: a systematic review and meta-analysis

Steffensen

Pereira

Dekkers

et al. 2016

European Journal of Endocrinology

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Objective: Type 2 diabetes (T2D) and Cushing's syndrome (CS) share clinical characteristics, and several small studies have recorded a high prevalence of hypercortisolism in T2D, which could have therapeutic implications. We aimed to assess the prevalence of endogenous hypercortisolism in T2D patients. Design: Systematic review and meta-analysis of the literature. Methods: A search was performed in SCOPUS, MEDLINE, and EMBASE for original articles assessing the prevalence of endogenous hypercortisolism and CS in T2D. Data were pooled in a random-effect logistic regression model and reported with 95% confidence intervals (95% CI). Results: Fourteen articles were included, with a total of 2827 T2D patients. The pooled prevalence of hypercortisolism and CS was 3.4% (95% CI: 1.5-5.9) and 1.4% (95 CI: 0.4-2.9) respectively. The prevalence did not differ between studies of unselected patients and patients selected based on the presence of metabolic features such as obesity or poor glycemic control (P = 0.41 from meta-regression). Imaging in patients with hypercortisolism (n = 102) revealed adrenal tumors and pituitary tumors in 52 and 14% respectively. Conclusions: Endogenous hypercortisolism is a relatively frequent finding in T2D, which may have therapeutic implications.

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Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Prevalence of hypercortisolism in type 2 diabetes patients: a systematic review and meta-analysis

Steffensen

Pereira

Dekkers

et al. 2016

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…Clinical features such as being overweight, having poor metabolic control, and hospitalization for DM were found to be associated with increased prevalence of CS in diabetics (8,27,28). Not only patient selection criteria but also differences in test methodology, cut-off values, and cortisol assay used are thought to be responsible for the large range of variation in performed studies (30).…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of CS among diabetic patients was reported to range from 0 to 9.4% depending on the associated features (7,8,9,27,28,29). Clinical features such as being overweight, having poor metabolic control, and hospitalization for DM were found to be associated with increased prevalence of CS in diabetics (8,27,28).…”

Section: Discussionmentioning

confidence: 99%

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Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

Karaca

Acmaz

Açmaz

et al. 2013

European Journal of Endocrinology

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Context: Prevalence of Cushing's syndrome (CS) in patients presenting with hirsutism is not well known. Objective: Screening of CS in patients with hirsutism. Setting: Referral hospital. Patients and other participants: This study was carried out on 105 patients who were admitted to the Endocrinology Department with the complaint of hirsutism. Intervention: All the patients were evaluated with low-dose dexamethasone suppression test (LDDST) for CS. Main outcome measure: Response to LDDST in patients presenting with hirsutism. Results: All the patients had suppressed cortisol levels following low-dose dexamethasone administration excluding CS. The etiology of hirsutism was polycystic ovary syndrome in 79%, idiopathic hirsutism in 13%, idiopathic hyperandrogenemia in 6%, and nonclassical congenital hyperplasia in 2% of the patients. Conclusion: Routine screening for CS in patients with a referral diagnosis of hirsutism is not required. For the time being, diagnostic tests for CS in hirsute patients should be limited to patients who have accompanying clinical stigmata of hypercortisolism.

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Endocrine Disorders that Cause Diabetes

Jennings

Hanley

2016

Textbook of Diabetes

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Is There Value in Routine Screening for Cushing’s Syndrome in Patients with Diabetes?

Cited by 61 publications

References 19 publications

DIAGNOSIS OF ENDOCRINE DISEASE: Prevalence of hypercortisolism in type 2 diabetes patients: a systematic review and meta-analysis

DIAGNOSIS OF ENDOCRINE DISEASE: Prevalence of hypercortisolism in type 2 diabetes patients: a systematic review and meta-analysis

Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

Endocrine Disorders that Cause Diabetes

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