Pathophysiological Link between Insulin Resistance and Adrenal Incidentalomas |
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| Authors: | Jordan A Higgs Alyssa P Quinn Kevin D Seely Zeke Richards Shad P Mortensen Cody S Crandall Amanda E Brooks |
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| Affiliation: | 1.College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA; (J.A.H.); (A.P.Q.); (Z.R.); (S.P.M.); (C.S.C.);2.Department of Research and Scholarly Activity, Rocky Vista University, Ivins, UT 84738, USA; |
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| Abstract: | Adrenal incidentalomas are incidentally discovered adrenal masses greater than one centimeter in diameter. An association between insulin resistance and adrenal incidentalomas has been established. However, the pathophysiological link between these two conditions remains incompletely characterized. This review examines the literature on the interrelationship between insulin resistance and adrenal masses, their subtypes, and related pathophysiology. Some studies show that functional and non-functional adrenal masses elicit systemic insulin resistance, whereas others conclude the inverse. Insulin resistance, hyperinsulinemia, and the anabolic effects on adrenal gland tissue, which have insulin and insulin-like growth factor-1 receptors, offer possible pathophysiological links. Conversely, autonomous adrenal cortisol secretion generates visceral fat accumulation and insulin resistance. Further investigation into the mechanisms and timing of these two pathologies as they relate to one another is needed and could be valuable in the prevention, detection, and treatment of both conditions. |
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| Keywords: | adrenal incidentaloma insulin resistance autonomous cortisol secretion differential diagnosis of adrenal masses subclinical hypercortisolism adrenalectomy pancreatic beta-cells diabetes mellitus metabolic syndrome |
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