Mild autonomous cortisol secretion (MACS) from benign adrenal tumors is associated with increased cardiometabolic risk, according to a study published in the Annals of Internal Medicine. Alessandro Prete, MD, and colleagues examined cardiometabolic disease burden and steroid excretion in 1,305 persons from 14 endocrine secondary and tertiary care centers with benign adrenal tumors, with and without MACS. Of participants, 49.7% (64.1% women), 34.6% (67.2% women), 10.7% (73.6% women), and 5.0% (86.2% women) had non-functioning adrenal tumor (NFAT), possible MACS (MACS-1), definitive MACS (MACS2), and Cushing syndrome (CS), respectively. 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 three or more antihypertensives, 1.31 and 2.22, respectively). Dr. Prete, et al. noted an increase in glucocorticoid excretion from NFAT over MACS-1 and MACS-2 to CS, whereas a decrease in androgen excretion was observed.
