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The following is a summary of “Prevalence and Predictive Features of CT-Derived Nonalcoholic Fatty Liver Disease in Metabolically Healthy MACS,” published in the January 2025 issue of Endocrinology by Candemir et al.     

People who are metabolically healthy with mild autonomous cortisol secretion (MACS) are at increased risk for cardiometabolic disorders, including nonalcoholic fatty liver disease (NAFLD).  

Researchers conducted a retrospective study to investigate the prevalence and predictors of NAFLD in metabolically healthy people with MACS.  

They involved 40 people with MACS and 60 with nonfunctioning adrenal incidentalomas (NFAI), matched for age, gender, and body mass index (BMI). Conditions that may lead to NAFLD, such as diabetes or liver disease, were excluded, and NAFLD was evaluated using unenhanced abdominal computed tomography (CT) and noninvasive fatty liver indices.  

The results showed that people with MACS had significantly lower mean liver attenuation values (Hounsfield units, HU) than those with NFAI (P=0.001). The visceral adiposity index, hepatic steatosis index, and fatty liver index were significantly higher in the MACS group than in the NFAI group (P=0.009, P=0.002, P=0.023, respectively). However, no significant association was found between mean liver HU values and these indices. After the 1 mg dexamethasone suppression test (DST), the serum cortisol level was significantly associated with mean liver HU value, independent of other traditional risk factors.  

They concluded that MACS was associated with an increased risk of NAFLD, with serum cortisol after the 1 mg DST serving as an independent predictor.  

Source: onlinelibrary.wiley.com/doi/abs/10.1111/cen.15194