(HealthDay News) — Mild autonomous cortisol secretion (MACS) from benign adrenal tumors is associated with increased cardiometabolic risk, according to a study published online in the Annals of Internal Medicine.

Alessandro Prete, MD, from the University of Birmingham in the United Kingdom, and colleagues examined cardiometabolic disease burden and steroid excretion in 1305 persons from 14 endocrine secondary and tertiary care centers with benign adrenal tumors with and without MACS.

Of the participants, 49.7% (64.1% women), 34.6% (67.2% women), 10.7% (73.6% women), and 5.0% (86.2% women) had nonfunctioning adrenal tumor (NFAT), possible MACS (MACS-1), definitive MACS (MACS-2), and Cushing syndrome (CS), respectively. The researchers found that the prevalence and severity of hypertension were higher in MACS-2 and CS than in NFAT (adjusted prevalence ratios [aPRs] for hypertension: 1.15 and 1.37, respectively; aPRs for use of 3 or more antihypertensives: 1.31 and 2.22, respectively). Compared with NFAT, type 2 diabetes was more prevalent in CS (aPR, 1.62), and the likelihood of requiring insulin therapy was increased for MACS-2 and CS (aPRs, 1.89 and 3.06, respectively). There was an increase noted in glucocorticoid excretion from NFAT over MACS-1 and MACS-2 to CS, while a decrease in androgen excretion was seen.


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“We advocate that all patients who are found to carry an adrenal incidentaloma are tested for MACS and have their blood pressure and glucose levels measured regularly,” a coauthor said in a statement.

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