Method for predicting the development of subclinical Cushing’s syndrome in patients with adrenal incidentalomas
Abstract
The article presents a comparative analysis of laboratory criteria for patients with adrenal incidentalomas. Based on the data of statistical analysis, additional criteria were identified, the presence of which indicates the degree of risk of developing subclinical Cushing’s syndrome within 3-5 years. The use of additional diagnostic criteria made it possible to assess the progression of target organ damage in patients in whom the hormonal activity of a benign adrenal neoplasm was not confirmed during the initial examination. To systematize and rationalize the examination of patients with adrenal incidentaloma, a diagnostic algorithm has been developed. The autonomous hypersecretion of cortisol by the formation of the adrenal gland is determined. After additional examination, patients are distributed to one of the following groups: 1) hormonally inactive adrenal formation/group of low risk of SCS development; 2) patients with SCS/high risk of developing SCS. Treatment tactics are formed individually depending on the age and severity of the comorbidity.
About the Authors
A. V. Velichko
ГУ «РНПЦ радиационной медицины и экологии человека»
Russian Federation
Russian Federation
A. A. Chulkov
ГУ «РНПЦ радиационной медицины и экологии человека»
Russian Federation
Russian Federation
Yu. I. Yarets
ГУ «РНПЦ радиационной медицины и экологии человека»
Russian Federation
Russian Federation
I. G. Savasteeva
ГУ «РНПЦ радиационной медицины и экологии человека»
Russian Federation
Russian Federation
V. M. Mitsura
ГУ «РНПЦ радиационной медицины и экологии человека»
Russian Federation
Russian Federation
References
1. Бельцевич, Д.Г. Клинические рекомендации Российской ассоциации эндокринологов по дифференциальной диагностике инциденталом надпочечников / Д.Г. Бельцевич [и др.] // Эндокринная хирургия. - 2016. - №4. - С.31-42.
2. Preclinical Сushing’s syndrome in adrenal «incidentalomas»: Comparison with adrenal Сushing’s syndrome / M. Reincke [et al.] // Journal of Clinical Endocrinology and Metabolism. - 1992. - Vol. 75, № 3. - P. 826-832.
3. Subclinical hypercortisolism and CT appearance in adrenal incidentalomas: a multicenter study from Southern Sweden / H. Olsen [et al.] // Endocrine. - 2012. - Vol. 42, № 1. - P. 73-164.
4. AACE/AAES Adrenal Incidentaloma guidelines / A. Martha [et al.] // Endocrine Practice. - 2009. - Vol. 15, № 5. - P. 3-450.
5. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors / M. Fassnacht [et al.] // European Journal of Endocrinology. - 2016. - Vol. 175, № 2. - P. G1-G34.
6. Exploration and management of adrenal incidentalomas. French Society of Endocrinology Consensus / A. Tabarin [et al.] // Annales d’Endocrinologie. - 2008. - Vol. 69, № 6. - P. 487-500.
7. Long-term follow-up in adrenal incidentalomas: an Italian multicenter study / V. Morelli [et al.] // Journal of Clinical Endocrinology and Metabolism. - 2014. - Vol. 99, № 3. - P. 827-834.
8. Третьяк, Е.Э. Скрининг субклинического синдрома Кушинга у пациентов с артериальной гипертензией / Е.Э. Третьяк, С.М. Черенько // Клінічна ендокринологія та ендокринна хірургія. - 2018. - Т. 61, № 1. - С. 25-32.
9. Progressively increased patterns of subclinical cortisol hypersecretion in adrenal incidentalomas differently predict major metabolic and cardiovascular outcomes: a large cross-sectional study / G. Di Dalmazi [et al.] // The European Journal of Endocrinology. - 2005. - Vol. 166, № 4. - P. 669-677.
10. Nonalcoholic fatty liver disease in subjects with adrenal incidentaloma / L. Papanastasiou [et al.] // European Journal of Clinical Investigation. - 2012. - Vol. 42, № 11. - P. 1165-1172.
11. AME Position Statement on adrenal incidentaloma / M. Terzolo [et al.]. // European Journal of Endocrinology. - 2011. - Vol. 164, № 6. - P. 851-870.
Review
For citations:
Velichko A.V., Chulkov A.A., Yarets Yu.I., Savasteeva I.G., Mitsura V.M. Method for predicting the development of subclinical Cushing’s syndrome in patients with adrenal incidentalomas. Medical and Biological Problems of Life Activity. 2022;(2):53-59. (In Russ.)
Views: 134
Email this article 