ReviewNature reviews. Endocrinology2024
Mild autonomous cortisol secretion: pathophysiology, comorbidities and management approaches.
Review in Nature reviews. Endocrinology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07573163 (A Randomized Clinical Trial of Tirzepatide Following Adrenalectomy in Mild Autonomous Cortisol Secretion), which is not on this map. Cited by 66 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Clinical Trial of Tirzepatide Following Adrenalectomy in Mild Autonomous Cortisol Secretion
Who cites it
66 citing papers in PubMed, 3 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Cardiometabolic Risk Parameters in "Nonfunctioning" Adrenal Incidentalomas: A Systematic Review and Meta-analysis.The Journal of clinical endocrinology and metabolism · 2026Pooled it
- Guideline
- Exploring the high prevalence, comorbidities, and indicators of mild autonomous cortisol secretion in primary aldosteronism: a cohort study and systematic review.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Pooled it
- The Functional Side of Multiple Endocrine Neoplasia Type 1-Associated Adrenal Disease: Mild Autonomous Cortisol Secretion.Diseases (Basel, Switzerland) · 2026Article
- Adrenal incidentalomas: 1 mg dexamethasone test result in the context of cardiometabolic risk.Journal of endocrinological investigation · 2026Article
- Risk factors for early postoperative complications after minimally invasive adrenalectomy: a single-centre retrospective cohort study of more than 800 patients.Surgical endoscopy · 2026Article
- Specialist consultation improves underdiagnosis of surgical adrenal incidentaloma: a TriNetX database investigation.The Canadian journal of urology · 2026Article
- Role of NP-59 SPECT/CT in the Management of Mild Autonomous Cortisol Secretion.Journal of clinical medicine · 2026Article
- Cancer incidence in endogenous hypercortisolism.Journal of endocrinological investigation · 2026Article
- Hypercortisolism: Causes, Consequences and Clinical Significance - A Review of Pathophysiology.Diabetes, obesity & metabolism · 2026Review
- Secondary Adrenal Insufficiency Presenting With Severe Hyponatremia in an Elderly Patient With Primary Aldosteronism Suggesting Underlying Autonomous Cortisol Secretion.Clinical case reports · 2026Article
- Is Hypercortisolism Treatable? Which Patients Should Be Treated and How-A Practical Guide for Clinicians.Diabetes, obesity & metabolism · 2026Review
- Hypercortisolism: An Under-Recognised Pathway Linked to Multi-System Complications.Diabetes, obesity & metabolism · 2026Review
- How Common Is Hypercortisolism in Patients With Type 2 Diabetes? Risk Factors, Epidemiology, and Making a Diagnosis Using a Dexamethasone Suppression Test.Diabetes, obesity & metabolism · 2026Review
- Article
- Graded Electrolyte Disturbances Across the Spectrum of Autonomous Cortisol Secretion in Patients with Adrenal Incidentaloma: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Perioperative management of patients with primary aldosteronism: a practical approach for the endocrinologist.Endocrine connections · 2026Review
- A Real-World Study in Non-Functional Adrenal Tumours: Refining Central DXA Results.Journal of clinical medicine · 2026Article
- Update and Practical Recommendations for the Use of Medical Treatment of Cushing Syndrome.Endocrine reviews · 2026Review
- Effects of short-term metyrapone treatment on glycaemic control in patients with mild autonomous cortisol secretion: a pilot study.Endocrine · 2026Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The majority of incidentally discovered adrenal tumours are benign adrenocortical adenomas and the prevalence of adrenocortical adenomas is around 1-7% on cross-sectional abdominal imaging. These can be non-functioning adrenal tumours or they can be associated with autonomous cortisol secretion on a spectrum that ranges from rare clinically overt adrenal Cushing syndrome to the much more prevalent mild autonomous cortisol secretion (MACS) without signs of Cushing syndrome. MACS is diagnosed (based on an abnormal overnight dexamethasone suppression test) in 20-50% of patients with adrenal adenomas. MACS is associated with cardiovascular morbidity, frailty, fragility fractures, decreased quality of life and increased mortality. Management of MACS should be individualized based on patient characteristics and includes adrenalectomy or conservative follow-up with treatment of associated comorbidities. Identifying patients with MACS who are most likely to benefit from adrenalectomy is challenging, as adrenalectomy results in improvement of cardiovascular morbidity in some, but not all, patients with MACS. Of note, diagnosis and management of patients with bilateral MACS is especially challenging. Current gaps in MACS clinical practice include a lack of specific biomarkers diagnostic of MACS-related health outcomes and a paucity of clinical trials demonstrating the efficacy of adrenalectomy on comorbidities associated with MACS. In addition, little evidence exists to demonstrate the efficacy and safety of long-term medical therapy in patients with MACS.
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Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.