Cardiovascular Risk Markers in Adults With Adrenal Incidentaloma and Mild Autonomous Cortisol Secretion

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Metabolic Health

Background:

• Mild autonomous cortisol secretion (MACS) is common in adrenal adenomas.
• MACS is associated with increased cardiovascular mortality, but mechanisms remain unclear.

Purpose of the Study:

• Investigate mechanisms linking MACS and cardiovascular mortality in adults with adrenal adenoma.
• Assess endothelial function and glucose/insulin metabolism in MACS patients.

Main Methods:

• Cross-sectional study comparing 20 adults with adrenal adenoma and MACS to 20 controls with nonfunctioning adrenal adenoma.
• Measured reactive hyperemia index (RHI) for endothelial function and performed 24-hour ambulatory blood pressure monitoring (24h AMBP).
• Assessed insulin secretion and sensitivity via fasting and postprandial glucose and insulin levels.

Main Results:

• No significant difference in fasting RHI between groups; postprandial RHI was higher in MACS patients.
• No significant differences in 24h AMBP or Matsuda index.
• MACS patients showed higher fasting and postprandial glucose levels, with a lower insulinogenic index, indicating impaired insulin secretion.

Conclusions:

• Adults with adrenal adenoma and MACS do not exhibit fasting endothelial dysfunction; postprandial endothelial function may be improved.
• Fasting and postprandial hyperglycemia with reduced insulin secretion in MACS patients may contribute to their increased cardiovascular mortality risk.