Introduction: Subclinical Cushing’s syndrome (SCS) is defined as biochemical overt cortisol excess in the absence of the clas- sical signs and symptoms of Cushing’s disease. The prevalence of SCS is reported as between approximately 5% and 24% in patients with adrenal incidentalomas (AI). SCS has increased cardiovascular and metabolic risk factors, and metabolic syndrome. Recently some studies demonstrated oxidative stress enhancement in Cushing’s disease. Ischemia-modified albumin (IMA) is a marker of ischemia and oxidative stress and is increased in different clinical conditions such as cardiovascular diseases and metabolic syndro- me. However, it has not been investigated in the patients with SCS. We aimed to evaluate serum IMA levels in the patients with SCS.
Materials and methods: A total of 128 patients with AI were included in this study (17 patients with SCS and 111 patients with non-functional adenomas (NFA)). All patients were evaluated for the presence of adrenal masses using adrenal computed tomo- graphy (CT) scans. Serum IMA levels were measured by using a colorimetric method.
Results: Serum IMA levels were significantly higher in SCS patients than in NFA patients (p < 0.05). Serum IMA was signifi- cantly correlated with waist circumference, low-density lipoprotein (LDL) levels and SCS. Furthermore, regression analysis revealed that serum IMA levels are independent and positively associated only with SCS.
Conclusion: We concluded that elevated serum IMA levels might be accepted as a useful marker in patients with SCS. In order to reveal the pathological role of IMA levels in patients with SCS more studies are required.
Ischemia-modified albumin, adrenal incidentaloma, subclinical Cushing’s syndrome, oxidative stress