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The most used screening test is the overnight cortisol after 1\u00a0mg of dexamethasone suppression test (DST), with a false positive rate ranging from 3.7 to 21%. The prevalence of CS among obese patients is generally about 1%, except for two studies which reported higher prevalence. For obese patients, 1\u00a0mg DST and late-night salivary cortisol are the most accurate screening tests for CS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Clinical expertise remains the mainstay to identify which subjects should be screened for CS. The evaluation of the clinical stigmata of CS and the combination with clinical comorbidities typical of CS are the stronger predictors of CS. In addition, we could hypothesize that in patients with T2DM, overnight 1\u00a0mg DST is the more accurate screening test for CS. By contrast, in patients with obesity both LNSC and overnight 1\u00a0mg DST could be equally used for the screening of hypercortisolism.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40618-024-02455-7","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T05:25:13Z","timestamp":1727760313000},"page":"47-59","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Who and how to screen for endogenous hypercortisolism in type 2 diabetes mellitus or obesity"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8088-4947","authenticated-orcid":false,"given":"Valentina","family":"Guarnotta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Reimondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,1]]},"reference":[{"key":"2455_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000314297","volume":"92","author":"C Steffensen","year":"2010","unstructured":"Steffensen C, Bak AM, Z\u00f8ylner Rubeck K, J\u00f8rgensen JOL (2010) Epidemiology of Cushing\u2019s syndrome. 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