An Overlooked Disease: Minimal Autonomous Cortisol Secretion (MACS). A Narrative Review

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-04-30 DOI:10.2174/0118715303266569231129101847

Stephanie Farah, Leah Nasr, Jocelyne Eid Fares

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引用次数: 0

Abstract

Background: A far more common disease than Cushing’s syndrome is subclinical hypercortisolism or mild autonomous cortisol secretion (MACS), with an overall prevalence of 0.2-2%. Objective: This review aims to shed light on the prevalence, screening and diagnostic criteria, comorbidities, and management of Mild Autonomous Cortisol Secretion (MACS). Methods: Studies eligible targeted MACS regarding prevalence, screening, comorbidities, management, and clinical outcome. This is a mini-review. IRB approval was not needed. Results: The 1 mg Dexamethasone suppression test (DST) remains the first screening test. MACS is associated with adverse cardiometabolic and renal outcomes, osteoporosis and osteopenia, immunodeficiency, depression, coagulopathy, and sarcopenia. Surgery is the gold standard treatment. Medical therapy is recommended when surgery is contraindicated or not feasible. Clinically silent hypercortisolism is a frequent entity that necessitates early detection and treatment. The production of cortisol should be looked at as a spectrum where subtle, undetectable levels can still be produced. They know its association with adverse health outcomes. Conclusion: MACS is no longer considered an asymptomatic disorder; repeated hormonal and functional tests are crucial to prevent multiorgan damage.

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一种被忽视的疾病：最低自主皮质醇分泌 (MACS)。叙述性综述

背景：亚临床皮质醇增多症或轻度皮质醇自主分泌症（MACS）是一种比库欣综合征更为常见的疾病，总发病率为 0.2-2%。目的：本综述旨在揭示皮质醇分泌过多症（MACS）的临床表现：本综述旨在阐明轻度自主皮质醇分泌症（MACS）的发病率、筛查和诊断标准、并发症和管理。研究方法：符合条件的研究针对 MACS 的患病率、筛查、合并症、管理和临床结果。这是一篇微型综述。无需获得 IRB 批准。研究结果1 毫克地塞米松抑制试验（DST）仍是首选筛查试验。MACS 与不良的心脏代谢和肾脏结果、骨质疏松症和骨质疏松症、免疫缺陷、抑郁、凝血功能障碍和肌肉疏松有关。手术是治疗的金标准。手术禁忌或不可行时，建议采用药物治疗。临床上无症状的皮质醇过多症是一种常见病，需要及早发现和治疗。皮质醇的产生应被视为一个频谱，在这个频谱中仍可能产生微妙的、检测不到的皮质醇水平。他们知道皮质醇与不良的健康后果有关。结论MACS不再被认为是一种无症状的疾病；反复进行激素和功能检测对于预防多器官损伤至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464