# Skeletal Consequences of Mild Autonomous Cortisol Secretion

> **NIH NIH K23** · MAYO CLINIC ROCHESTER · 2021 · $157,112

## Abstract

PROJECT SUMMARY/ABSTRACT
Adrenal adenomas affect 5%-10% of the population, discovered annually in about 4 million adults in United
States. Patients with adrenal adenomas demonstrate an abnormal steroid secretion and metabolism, the most
prevalent being called “subclinical” mild, autonomous cortisol secretion (MACS). Available limited evidence
suggests that patients with MACS suffer from very high-rates of vertebral fractures, many times not correlated
with deterioration of bone density. Understanding how MACS affects bone metabolism and leads to fractures is
significantly limited by heterogeneous patient populations and the multifactorial etiology of bone disease.
The overall objective of the proposed project is to understand the epidemiology of fractures in patients with
adrenal tumors and MACS, and to identify the elements of abnormal steroid secretion and metabolism that
predict bone disease, and ultimately fractures. This will be accomplished in three specific aims. In Aim 1, the
Olmsted county population will be accessed through the Rochester Epidemiology Project (REP) to determine
the prevalence and incidence of fragility fractures in patients with adrenal tumors overall, and the effect of
MACS severity on fragility on fracture occurrence will be established. The experiments proposed in Aim 2 will
determine if the abnormal steroid metabolome observed in patients with MACS is associated with impaired
bone density, quality, structure and metabolism that, in turn, are associated with an increased risk of both
vertebral and non-vertebral fractures. The experiments proposed in Aim 3 will determine if the abnormal
circadian pattern of cortisol secretion in patients with MACS is associated with abnormal calcium metabolism
and alterations in bone turnover markers.
The proposed career development award and associated candidate training address an important health
problem of skeletal health in patients with MACS and prepare the candidate for an independent career in
research, meeting the goal of the NIH mentored Patient-Oriented Research Career Development Award
(Parent K23 - Independent Clinical Trial Not Allowed), PA-18-375. The exceptional resources and institutional
support at Mayo Clinic, outstanding multi-disciplinary mentorship team, and proposed career development
activities will allow the candidate to achieve her long-term goal of becoming an independent investigator and
nationally recognized expert on steroid effects on bone health and design interventions that are effective in
improving skeletal health of patients with adrenal tumors.

## Key facts

- **NIH application ID:** 10160897
- **Project number:** 5K23DK121888-03
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** Irina Bancos
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $157,112
- **Award type:** 5
- **Project period:** 2019-08-19 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10160897

## Citation

> US National Institutes of Health, RePORTER application 10160897, Skeletal Consequences of Mild Autonomous Cortisol Secretion (5K23DK121888-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10160897. Licensed CC0.

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