The relationship between mild autonomous cortisol secretion and metabolic diseases in cases with adrenal incidentaloma
Endokrynologia Polska, cilt.76, sa.2, ss.172-181, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 76 Sayı: 2
- Basım Tarihi: 2025
- Doi Numarası: 10.5603/ep.102706
- Dergi Adı: Endokrynologia Polska
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, Directory of Open Access Journals
- Sayfa Sayıları: ss.172-181
- Anahtar Kelimeler: adrenal incidentalomas, mild autonomous cortisol secretion, cardiovascular risk, metabolic comorbidities, endocrinology
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: This study investigates the link between mild autonomous cortisol secretion (MACS) in adrenal incidentaloma (AI) patients and the occurrence and severity of cardiovascular and metabolic comorbidities. It aims to provide a detailed overview of this relationship, highlight gaps in current research, and propose directions for future studies. Material and methods: We conducted a retrospective analysis at Ankara City Hospital’s Endocrine Department outpatient clinic, reviewing 627 AI patients from February 2019 to May 2021. The study involved a detailed analysis of clinical records, hormonal evaluations, and imaging, focusing on differentiating MACS from non-functioning adrenal incidentalomas (NFAI) and examining the impact of MACS on associated health conditions. Results: The study found that MACS patients had a statistically higher incidence of diabetes mellitus (35% vs. 20%), hypertension (60% vs. 45%), hyperlipidaemia (40% vs. 25%), and coronary artery disease (30% vs. 15%) compared to the NFAI group. Independent predictors of MACS included the presence of bilateral adrenal masses, larger adrenal mass diameter (with a cutoff value of ≥ 18.5 mm, showing 83% sensitivity and 56% specificity for predicting MACS, and lower dehydroepiandrosterone sulphate (DHEAS) levels (≤ 49.31 µg/dL predicting MACS, with 61% sensitivity and 73% specificity). Conclusion: This research underscores the critical clinical implications of detecting MACS in AI patients, particularly its association with increased cardiovascular and metabolic risks. It calls for vigilant screening and a comprehensive management approach for affected patients. Additionally, the findings highlight the need for further studies to improve patient care and outcomes in this population.