Screening for Cushing's syndrome: Is it worthwhile?
Screening for Cushing's syndrome: Is it worthwhile?
复制标题
DOI：
10.1007/s11102-015-0634-9
复制
发表时间：
2015-04-01
期刊：
影响因子：
3.8
通讯作者：
Shimon, Ilan
中科院分区：
文献类型：
--
作者：
Shimon, Ilan
前言库欣综合征(CS)是一种罕见的疾病，以一系列体征和症状为特征，在没有皮质醇分泌升高的普通人群中也很常见。在过去的几年中，更多的CS患者被发现得更早，病情较轻。其中许多患者是在对某些或个别疾病如体重增加、糖尿病(DM)、高血压、骨质疏松症、白细胞计数升高等进行筛查时被诊断出来的。方法在这篇综述文章中，引用的研究中最受欢迎的筛查试验是1 mg地塞米松抑制试验。结论库欣不够频繁，不足以支持在病态肥胖症和2型糖尿病患者中使用常规筛查。此外，仅有1%的高血压患者有CS继发性高血压。然而，应该考虑对患有顽固性糖尿病和/或高血压的年轻患者进行筛查。在骨质疏松和脊椎骨折的患者中，高达5%的患者被诊断为亚临床皮质醇增多症；其中大多数人患有肾上腺腺瘤。对肾上腺偶发瘤患者进行CS筛查很重要，许多研究表明这些患者中库欣或亚临床CS的患病率很高(接近10%)。
Introduction Cushing's syndrome (CS) is a rare disease characterized by a collection of signs and symptoms, also common in the general population without elevated cortisol secretion. During the last years more patients with CS are identified earlier and with milder disease. Many of these patients are diagnosed during screening efforts performed for certain or isolated complaints like weight gain, diabetes mellitus (DM), hypertension, osteoporosis, elevated white blood cell counts and more.Methods In this review article the most popular screening test performed in the studies cited was the 1-mg dexamethasone suppression test.Conclusions Cushing is not frequent enough to support the use of routine screening in patients with morbid obesity and type 2 DM. Also only 1 % of hypertensive patients have secondary hypertension due to CS. However, screening should be considered in young patients with resistant DM and/or hypertension. Among patients with osteoporosis and vertebral fractures up to 5 % were diagnosed with subclinical hypercortisolism; most of these had adrenal adenoma. Screening for CS is important in subjects with adrenal incidentaloma, and many studies show a high prevalence (similar to 10 %) of Cushing or subclinical CS in these patients.