Prevalence of Mild Autonomous Cortisol Secretion in Adrenal Incidentalomas and the Significance of Subcentimeter Adrenal Nodules: A Single-Center Cohort Study
Authors' conclusion
MACS is the most common hormonal abnormality amongst AI. Hormonal evaluation should be considered for subcentimeter adrenal nodules. Minimally invasive surgery is a safe treatment for MACS which may reduce metabolic risks but seldom performed in this population.
Study context
- Population
- Consecutive patients referred to medical and surgical endocrine clinics for adrenal incidentalomas (AI) at a tertiary institution, June 2012–May 2019, Asian population; 52.1% males, median age 63 years
- Participants
- 340 patients
- Exposure
- Mild autonomous cortisol secretion (MACS) vs Non-functional
- MACSn = 80
- Outcome
- Hormonal abnormality among AI
Methodological detailssingle-centre, consecutive patients, tertiary institution
- Single-centre
- Consecutive patients
- Tertiary institution
Main finding
As reported in the abstract
Functional nodules
116
34.1%
MACS, most common hormonal abnormality
23.5%
Observational data: associations, not effects.
Further findings
5-year mortality
P = 0.046
- Overall survival · median follow-up 7.8 years · poorer OS with MACS
- P = 0.043
Functional nodules in AI <1 cm
- Functional among 50 patients with AI <1 cm
- 8 (16%)
Factors independently associated with MACS
- Female sex, aOR 3.03
- P < 0.001
- Larger AI size, aOR 1.25
- P = 0.010
- Hypertension, aOR 2.74
- P = 0.003
- Prediabetes, aOR 3.11
- P = 0.028
Adrenalectomy in MACS
- MACS patients who underwent adrenalectomy
- 16/80 (20%)
- New-onset hypertension, glucose intolerance, hyperlipidaemia or osteoporosis in surgical group on follow-up
- 0
Safety
Adrenalectomy complications
- All laparoscopic, without complications
- 0
Original publication
Prevalence of Mild Autonomous Cortisol Secretion in Adrenal Incidentalomas and the Significance of Subcentimeter Adrenal Nodules: A Single-Center Cohort Study. Endocr Pract. Published 30 July 2025. doi:10.
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