Hypercortisolism: An Under-Recognised Pathway Linked to Multi-System Complications.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search or pooled meta-analytic data
PubMed 42613968 · doi:10.1111/dom.71149
What was done
This narrative review synthesizes the evolving clinical understanding of hypercortisolism, focusing on milder presentations such as mild autonomous cortisol secretion (MACS). The authors describe the multi-system complications of chronic cortisol excess and review screening implications for patients with difficult-to-control metabolic and cardiovascular comorbidities.
What was found
The review notes that simple screening tests have detected hypercortisolism in over 20% of high-risk individuals with difficult-to-control diabetes and hypertension. Chronic hypercortisolism is described as contributing to multi-system morbidity and increased mortality through dysregulated glucose metabolism, lipid homeostasis, cardiovascular function, bone and muscle health, and neuropsychiatric health. Specific effect estimates or pooled statistical data were not reported in the abstract.
Why it matters
Broadening clinical suspicion of hypercortisolism beyond classic Cushing syndrome may uncover an under-diagnosed driver of treatment-resistant diabetes and hypertension, enabling targeted diagnostic and therapeutic approaches.
Limits
This is a non-systematic narrative review providing no primary patient data. Diagnostic test accuracy metrics, precise biochemical thresholds, and direct outcome data following intervention are not provided in the abstract.
Cited by
- supports Cortisol is physiologically required for the regulation of blood pressure and blood glucose.