According to researchers from the University of Birmingham, a benign tumor in the adrenal glands could lead to an overproduction of cortisol, which increases the risk of developing type 2 diabetes and high blood pressure.
- 10% of adults have an adrenal incidentaloma, a benign tumor of the adrenal glands.
- However, this adrenal incidentaloma causes in one out of two patients an overproduction of cortisol, which increases the risk of metabolic disease.
- Thus, people with mild autonomic cortisol secretion (MACS) are two to three times more likely to develop arterial hypertension and twice as likely to be treated with insulin in case of type 2 diabetes.
Type 2 diabetes and high blood pressure, two conditions affecting older or overweight adults, may be linked to adrenal incidentaloma, a benign mass on the adrenal glands, located above the kidneys.
In any case, this is the conclusion reached by researchers from the University of Birmingham (United Kingdom) in a study published in the Annals of Internal Medicine. According to them, this benign tumor leads to the overproduction of a steroid hormone linked to stress, cortisol, which increases the risk of developing type 2 diabetes or high blood pressure.
1.3 million people at risk in the UK
Up to 10% of adults have an adrenal incidentaloma. Previous small studies have already suggested that one in three adrenal incidentalomas produce excess cortisol, a condition called mild autonomic cortisol secretion (MACS).
The results of this new study show that MACS is actually much more prevalent than previously reported, as 1 in 2 patients in the study with adrenal incidentaloma had MACS. To reach this conclusion, the researchers conducted a large prospective study of 1,305 patients with adrenal incidentaloma to assess their risk of high blood pressure and type 2 diabetes as well as their cortisol production, comparing the patients with and without MACS. The data obtained by the researchers also shows that 70% of patients with MACS are women, mostly postmenopausal and over the age of 50.
Following these findings, researchers now estimate that up to 1.3 million adults in the UK may have MACS. Considering that approximately two out of three of these patients are women, MACS is potentially a key factor in women’s metabolic health, especially in women after menopause.
An increased risk of metabolic disease
This study is also the first to undertake a detailed analysis of steroid hormone production in patients by analyzing cortisol and other hormones using mass spectrometry in urine samples. The results, obtained on patients with MACS, are clear: they are three times more likely to be diagnosed with high blood pressure. As for patients with type 2 diabetes and MACS, they are also twice as likely to be treated with insulin, indicating that other drugs did not help manage their blood sugar.
For Dr. Alessandro Prete, first author of the study, these results show that “MACS is very common and is an important risk condition for high blood pressure and type 2 diabetes, especially in older women”.
According to him, “the impact of MACS on the risk of high blood pressure and type 2 diabetes has been underestimated so far”. Hence the importance for all patients with an adrenal incidentaloma to undergo a screening test for MACS. It is also important to regularly measure their blood pressure and glucose levels.
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