Key result
Mild autonomous cortisol secretion links to higher epicardial fat and cardio-metabolic risk despite unchanged intrahepatic lipids.
Why the study?
Mild autonomous cortisol secretion is linked to increased cardiovascular mortality, but whether patients with non-functioning adrenal adenoma also face elevated risk for cardio-metabolic comorbidities compared with individuals without adrenal tumors is unclear.
Does mild autonomous cortisol secretion (MACS) increase epicardial adiposity and adverse cardio-metabolic risk compared to non-functioning adrenal adenoma and controls?
Cross-Sectional (n=74)
No
Does mild autonomous cortisol secretion (MACS) increase epicardial adiposity and adverse cardio-metabolic risk compared to non-functioning adrenal adenoma and controls?
Absolute Event Rate: 2.45% vs 3.33%
p-value: p=0.708
Mild autonomous cortisol secretion in patients with adrenal adenoma is associated with increased epicardial adiposity and a worse cardio-metabolic risk profile compared to non-functioning adenomas and healthy controls.
May warrant cardio-metabolic assessment in NFA; hypothesis-generating and requires prospective confirmation.
Background Mild autonomous cortisol secretion (MACS) is associated with an increased cardiovascular mortality, but even patients with non-functioning adrenal adenoma (NFA) might be at risk for cardio-metabolic comorbidities compared to a control group with absence of an adrenal tumor (CON). Material and methods Seventyfour individuals were included in cross-sectional analysis [MACS: n=25(84% females), age: 63(55-67)years, BMI:27.00(24.20-30.50)kg/m 2 ; NFA: n=25(84%females), age: 61(54-68)years, BMI:28.50(27.50-32.20)kg/m 2 and CON: n=24 (75%females), age: 58 (51-64)years, BMI: 27.39(22.03-30.17) kg/m 2 ]. Visceral and ectopic fat stores, as well as heart function were assessed by magnetic resonance imaging and spectroscopy. Blood pressure was measured by standardized protocols. Blood was drawn in the fasting state and during an oral glucose tolerance test to assess glucose and lipid metabolism. Results The prevalence of hypertension (MACS:84% vs NFA:76% vs CON: 43.5%), dyslipidemia (MACS:96% vs NFA:80% vs CON:62.5%) and prediabetes (MACS:56% vs . NFA:72% vs CON:29.2%) was significantly different between the groups. Markers of glucose metabolism were worse in MACS and best in CON (HbA1c: 5.70 (5.40-5.90)% vs 5.50 (5.40-5.80)% vs 5.40 (5.27-5.60)%, p=0.043); HOMA_IR:2.91(2.19-4.15) vs 2.55 (1.57- 4.97) vs 1.73 (1.00-2.61), p=0.007). epicardial adipose tissue area was highest in MACS patients, followed by NFA, with lowest values in CON (MACS:1159.68 (930.38-1454.11) mm 2 vs NFA: 873.23 (638.03-1195.33) mm 2 vs CON:672.37 (549.44-890.30) mm 2 , p<0.001). No relevant between-group-differences in cardiac morphology, intramyocardial fat or intrahepatic fat were observed. Conclusions In this exploratory study, MACS was associated with epicardial adiposity and an adverse cardio-metabolic risk profile.
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Niziolek et al. (2026) conducted a cross-sectional in Adrenal adenoma (n=74). Mild autonomous cortisol secretion (MACS) vs. Controls without known adrenal adenoma was evaluated on Intrahepatic lipid content (p=0.708). Mild autonomous cortisol secretion was associated with significantly higher epicardial adipose tissue area and an adverse cardio-metabolic risk profile compared to controls, though the primary endpoint of intrahepatic lipid content did not differ.
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