title: Adrenal Mass: Insight Into Pathogenesis and a Common Link With Insulin Resistance.
abstract: Adrenal mass (AM) is a common incidental finding detected during radiological investigations with an estimated incidence of 4%. Subjects with AM do not show any physical signs of adrenal hormonal excess, although they are often insulin resistant. Interestingly, apparently nonfunctioning AMs are often associated with a high prevalence of insulin resistance (IR) and metabolic syndrome. However, it is unclear whether AM develops from a primary IR and compensatory hyperinsulinemia or whether IR is only secondary to the slight cortisol hypersecretion by AM. Further, the degree of IR has been directly reported to correlate to the size of AM, thus allowing one to hypothesize that compensatory hyperinsulinemia to IR could be mitogenic on the adrenal cortex acting through the activation of insulin and insulinlike growth factor 1 receptors. Thus, the aim of the present article is to review the current evidence on the link between AM and compensatory hyperinsulinemia to IR.
authors.affiliation: IOS and Coleman Medicina Futura Medical Center, 80011 Acerra, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Muscogiuri
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples, 80131 Naples, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: De Martino
authors.affiliation: IOS and Coleman Medicina Futura Medical Center, 80011 Acerra, Italy.
authors.forename: MariaRosaria
authors.initials: M
authors.lastname: Negri
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples, 80131 Naples, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pivonello
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples, 80131 Naples, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Simeoli
authors.affiliation: Department of Sports Science and Wellness, "Parthenope" University Naples, 80131 Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Orio
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples, 80131 Naples, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Pivonello
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples, 80131 Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D000311:Adrenal Glands / Q000033:anatomy & histology* / Q000378:metabolism / Q000473:pathology; D000818:Animals; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology / Q000473:pathology; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D024821:Metabolic Syndrome / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D009929:Organ Size
chemical_list: D007328:Insulin