Athimulam S, Delivanis D, Thomas M, et al. - In patients with adrenal adenomas, researchers conducted this cross-sectional study to assess the impact of mild autonomous cortisol secretion (MACS) on bone metabolism. Participants in the study were 213 patients with adrenal adenomas (22 Cushing syndrome (CS), 92 MACS and 99 nonfunctioning adrenal tumors (NFAT)). When compared to patients with MACS and NFAT, those with CS showed lower markers of bone formation. Severity of cortisol excess was inversely linked to sclerostin. Lower sclerostin level in patients with MACS reflects a decrease in osteocyte function or number related to chronic cortisol excess exposure. After adrenalectomy, increased bone turnover markers indicate restoration of favorable bone metabolism.