Long-term Beneficial Metabolic Effects of Adrenalectomy in Subclinical Cushing's Syndrome of Adrenal Incidentaloma

Long-term Effects of Adrenalectomy on Metabolic Syndrome, Glucose Metabolism, Lipid Metabolism, and Bone Metabolism in Subclinical Cushing's Syndrome of Adrenal Incidentaloma

Objective:

To determine the metabolic effects of the adrenalectomy in subclinical Cushing's syndrome of adrenal incidentaloma.

Methods:

234 subclinical cushing syndrome and adrenal incidentaloma will be randomly assigned into two groups(e.g adrenalectomy group and conservative treatment group).

Inclusion Criteria:

• patients with both unilateral adrenal incidentaloma and hypercortisolism

• definition of hypercortisolism

  • overnight dexamethasone suppression test, serum cortisol>1.8ug/dL
  • 24hr urine cortisol > upper reference limit

Exclusion Criteria:

• patients who took medication influencing cortisol secretion

• patients with definite clinical feature of cushing syndrome

  • moon face
  • abdominal striae
  • skin or proximal muscle atrophy

• metabolic syndrome, hyperthyroidism, hyperparathyroidism, chronic renal failure, rheumatic disease, hematologic disease

• patients who took following medication

  • insulin
  • oral hypoglycemic agent
  • thyroid hormone
  • anti-hyperlipidemic drug
  • sex hormone

• patients who taking steroid hormone or who took steroid hormone more than 2 weeks within 1 year

• psychiatric disease