In a single center study on incidental adrenal adenoma published recently (1), we reported on unexpectedly high occurrence of cardiovascular risk factors in subclinical Cushing’s syndrome (CS), among which hypertension (92%), obesity (50%), type 2 diabetes mellitus (DM) (42%), and alteration in serum lipid concentrations (50%). Their frequency was higher than that reported in the Italian multicentric study published just 2 months before ours (2), where hypertension, diabetes and obesity were reported in 41%, 8%, and 38% of subclinical CS patients, respectively. Moreover, frequencies found in our study were higher than those reported in CS (3, 4), and it is well known that patients with CS exhibit frequently glucose intolerance but less commonly overt DM (3, 4). Although the patients with subclinical CS were generally older than those with overt CS (1, 2), we hypothesized an overestimation of cardiovascular risk factors in our center, related to the small number of subjects evaluated. However, in 24 subclinical CS patients evaluated until now, the impaired glucose tolerance was found in similar proportion (62.5%) to those previously reported (1).
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Rosse et al. (2001) studied this question.