ArticleCardiovascular diabetology2026
Mild autonomous cortisol secretion (MACS) is associated with increased mortality in patients with adrenal adenomas only in the presence of type 2 diabetes: a retrospective cohort study.
Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypercortisolism and type 2 diabetes mellitus (T2D) independently contribute to an increased burden of cardiometabolic morbidity and mortality. However, data on the interaction of hypercortisolism and T2D are scarce-thus, we aimed to assess the cortisol-associated morbidity and mortality in the context of T2D and adrenal mild autonomous cortisol secretion (MACS).
methodsThis is a retrospective cohort study including 668 patients with adrenal adenomas, who were visiting the endocrine outpatient clinic at the Vienna General Hospital between 01.01.2000 to 31.12.2022. Of those, 151 were diagnosed with T2D at the time of their 1 mg dexamethasone suppression test (DST), other diabetes types were excluded. MACS was defined as a post 1 mg DST cortisol of > 1.8 µg/dL in the absence of Cushing's stigmata and after biochemical exclusion of ACTH-dependency. The database was linked to the governmental death registry and patients alive after 01.12.2024 were censored. Kaplan Meier curves and cox proportional hazard models were analyzed via RStudio.
resultsPatients with T2D had a higher post 1 mg DST cortisol level and were more often diagnosed with hypertension, dyslipidemia and cardiovascular disease (CVD) compared to those without T2D. Compared to patients with non-functioning adrenal adenomas (NFAA) without T2D, MACS was strongly linked to increased mortality only in T2D (HR 2.51 [CI95% 1.41-4.48], p < 0.01) but not in those without T2D, even after adjustment for age, sex, BMI, smoking, hypertension, dyslipidemia and CVD at baseline. The T2D cohort with MACS had higher HbA1c and a 3-fold elevation in CVD prevalence compared to those without hypercortisolism. They did not differ according to age, sex or other cardiometabolic risk parameters (dyslipidemia, hypertension, BMI).
conclusionsAmong patients with adrenal adenomas, MACS is related to increased CVD prevalence and is associated with mortality in patients with T2D. These findings highlight the need for confirmatory prospective studies incorporating larger sample sizes to further assess the importance of earlier identification and treatment of MACS in patients with T2D.
Indexed as
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.