Evaluation of Metabolic Parameters in Cushing's Syndrome

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The prevalence of metabolic syndrome (MetS) is estimated to be about onefourth of the worldwide adult population, while Cushing's syndrome (CS) is significantly rarer (estimated incidence of 2 per million). However, linking the two has not only therapeutic but also potential public health implications. The worldwide increase of obesity and MetS poses the problem of correctly identifying patients potentially hiding CS without indiscriminately screening all patients presenting one or more symptoms consistent with cortisol excess, which showed to be not cost-effective. CS is associated with hyperglycemia, protein catabolism, immunosuppression, hypertension, weight gain, neurocognitive changes, and mood disorders. Obesity, insulin resistance, hypertension, functional hypercortisolism (Endogenous/Exogenous), and MetS are common features. Early diagnosis and treatment are important because untreated CS may result in mortality due to associated metabolic risks.