Abstract
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.
Key words
mild autonomous cortisol secretion - subclinical hypercortisolism - adrenal incidentaloma
- vertebral fractures - osteoporosis - arterial hypertension - diabetes mellitus -
insulin resistance - obesity - metabolic syndrome
