Subclinical Autonomous Glucocorticoid Hypersecretion

Abstract

Subclinical autonomous glucocorticoid hypersecretion (SAGH) occurs in patients who have clinically nonfunctioning adrenal adenomas when cortisol secretion becomes autonomous and dysregulated, not fully restrained by pituitary feedback. Up to 20 percent of patients with adrenal incidentalomas have some form of
subclinical hormonal dysfunction and may represent a population at higher risk for metabolic disorders and cardiovascular disease. In most cases the degree of hypercortisolism is only slightly elevated than the physiologic daily production rate of cortisol. Dexamethasone suppression tests (DSTs) were employed extensively to screen for subclinical hypercortisolism in patients who have adrenal incidentaloma. Although adrenalectomy has been demonstrated to correct the biochemical abnormalities, its effect on long-term outcome and quality of life is unknown.