Adrenalectomy Improves Body Weight, Glucose, and Blood Pressure Control in Patients with Mild Autonomous Cortisol Secretion
Jung-Min Koh, Keeho Song, Mi Kyung Kwak, Sunghwan Suh, Beom-Jun Kim, Tae-Yon Sung, Jun Hyuk Hong, Byong Chang Jeong, Jae Hyeon Kim, Seung Hun Lee- Surgery
Objective:
To assess the metabolic effects of adrenalectomy in patients with mild autonomous cortisol secretion (MACS).
Background:
Despite retrospective studies showing the association of adrenalectomy for MACS with beneficial metabolic effects, there have been only two randomized prospective studies with some limitations to date.
Methods:
A prospective, multicenter study randomized 132 patients with adrenal incidentaloma without any features of Cushing’s syndrome but with serum cortisol>50 nmol/L after a 1 mg overnight dexamethasone suppression test (F-1mgODST) into an adrenalectomy group (n=66) or control group (n=66). The primary outcomes were changes in body weight, glucose, and blood pressure (BP).
Results:
Among the 118 participants who completed the study with a median follow-up duration of 48 months (range: 3–66), the adrenalectomy group (n=46) exhibited a significantly higher frequency of improved weight control, glucose control, and BP control (32.6%, 45.7%, and 45.7%, respectively) compared to the control group (n=46; 6.5%,
Conclusions:
Adrenalectomy improved weight, glucose, and BP control in patients with MACS.