Up to 10 percent of the population have benign lumps on their adrenal glands, triangular hormone-secreting glands that sit atop the kidneys. These tumors, known as adrenal incidentalomas, have previously been linked to the excessive production of the stress hormone cortisol.
Previous investigations estimate that one in three adrenal incidentalomas cause the adrenal glands to churn out too much cortisol, leading to a condition called Mild Autonomous Cortisol Secretion, or MACS.
We know that too much cortisol isn't good for the body. In the long run, this can cause metabolic issues, high blood pressure, and weak immune systems. A team of researchers interested in whether individuals with MACS are predisposed to elevated blood pressures and type 2 diabetes has released the results of their largest ever prospective study. This work involved a cohort of over 1,300 patients with adrenal incidentalomas and tracked their cortisol profiles over 24 hours.
Interestingly, they found that nearly half of the study participants with adrenal incidentalomas also had MACS. About 70 percent of the MACS-positive individuals were women over the age of 50. These results indicate that MACS could be a major factor influencing women's health, particularly for those at the postmenopausal age.
In addition, patients with MACS were twice as likely to have a type 2 diabetes diagnosis that required insulin treatments. This suggests that these patients may not be responding to other medical interventions to help regulate blood sugar levels. Furthermore, MACS-positive individuals were more likely to have high blood pressure that required them to take three or more pills daily to manage their blood pressure levels.
Just over 1 in 10 Americans have diabetes, and about 1 in 3 have prediabetes—statistics that have prompted several initiatives to manage the condition better. However, studies such as this underscore the complex physiological mechanisms at play (as opposed to only lifestyle factors) in developing these metabolic diseases.
"In conclusion, our study found that MACS is very frequent and is an important risk condition for high blood pressure and type 2 diabetes, especially in older women, and the impact of MACS on high blood pressure and type 2 diabetes risk has been underestimated until now," commented Alessandro Prete, first author of the publication.
The researchers are hopeful that these findings will help raise awareness of the prevalence and importance of MACS on metabolic health. They are calling for physicians to be more vigilant with patients with adrenal incidentalomas, testing them regularly to pick up the early signs of potentially dangerous blood pressure and blood glucose imbalances.
