[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100620765":3},{"organization":4,"armGroups":7,"interventions":23,"overallOfficials":29,"centralContacts":35,"locations":41,"responsibleParty":61,"collaborators":63,"id":67,"slug":68,"hasResults":69,"nctId":70,"briefTitle":71,"officialTitle":72,"acronym":73,"eligibilityCriteria":74,"healthyVolunteers":69,"sex":75,"minAge":76,"maxAge":29,"enrollmentInfo":77,"targetDuration":29,"studyType":80,"phases":81,"briefSummary":83,"conditions":84,"keywords":89,"overallStatus":43,"whyStopped":29,"lastUpdateSubmitDate":108,"lastUpdatePostDateStruct":109,"startDateStruct":112,"completionDateStruct":114,"leadSponsor":116,"locationsCount":117},{"fullName":5,"class":6},"University of Texas Southwestern Medical Center","OTHER",[8,14,19],{"label":9,"type":10,"description":11,"interventionNames":12},"Arm 1: Adrenalectomy (MACS)","ACTIVE_COMPARATOR","Adults with mild autonomous cortisol secretion (MACS) who are clinically eligible for adrenalectomy undergo unilateral adrenalectomy as part of standard care. Participants complete all metabolic assessments before and after treatment.",[13],"Procedure: Intervention 1: Adrenalectomy",{"label":15,"type":10,"description":16,"interventionNames":17},"Arm 2: Semaglutide (MACS)","Adults with MACS receive once-weekly semaglutide for 26 weeks using FDA-approved weight-management dosing. Participants undergo the same assessments as the surgery group.",[18],"Drug: Intervention 2: Semaglutide",{"label":20,"type":10,"description":21,"interventionNames":22},"Arm 3: Semaglutide (Matched Controls)","Matched adults without adrenal tumors receive semaglutide using the same dosing schedule as MACS participants. This arm allows comparison of semaglutide responses between individuals with and without cortisol dysregulation.",[18],[24,30],{"type":25,"name":26,"description":27,"armGroupLabels":28,"otherNames":29},"PROCEDURE","Intervention 1: Adrenalectomy","Surgical removal of one adrenal gland performed by an endocrine surgeon following institutional standard-of-care practices. Includes postoperative monitoring for adrenal insufficiency and routine clinical follow-up.",[9],null,{"type":31,"name":32,"description":33,"armGroupLabels":34,"otherNames":29},"DRUG","Intervention 2: Semaglutide","Once-weekly subcutaneous semaglutide administered according to FDA-approved titration for chronic weight management (0.25 mg to 2.4 mg weekly as tolerated). Participants receive training on injection technique, dose escalation, and safety monitoring.",[15,20],[36],{"name":37,"role":38,"phone":39,"phoneExt":29,"email":40},"Oksana Hamidi, DO, MSCS","CONTACT","214-645-6397","oksana.hamidi@utsouthwestern.edu",[42],{"facility":5,"status":43,"city":44,"state":45,"zip":46,"country":47,"countryCode":48,"cosmosGeoPoint":49,"geoPoint":54,"contacts":55},"RECRUITING","Dallas","Texas","75390","United States","US",{"type":50,"coordinates":51},"Point",[52,53],-96.80667,32.78306,{"lat":53,"lon":52},[56,58,59],{"name":37,"role":38,"phone":57,"phoneExt":29,"email":40},"2146456397",{"name":29,"role":38,"phone":29,"phoneExt":29,"email":40},{"name":37,"role":60,"phone":29,"phoneExt":29,"email":29},"PRINCIPAL_INVESTIGATOR",{"type":60,"investigatorFullName":37,"investigatorTitle":62,"investigatorAffiliation":5,"oldNameTitle":29,"oldOrganization":29},"Associate Professor",[64],{"name":65,"class":66},"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)","NIH","100620765","impact-macs-adrenalectomy-vs-semaglutide-for-metabolic-outcomes-in-mild-autonomous-cortisol-secretion-100620765",false,"NCT07361874","IMPACT-MACS: Adrenalectomy vs Semaglutide for Metabolic Outcomes in Mild Autonomous Cortisol Secretion","IMPACT-MACS Study: Investigating the Mechanisms, Pathophysiology, and Cardiometabolic Treatment in Mild Autonomous Cortisol Secretion","IMPACT-MACS","Inclusion Criteria:\n\n* Adults ≥18 years\n* MACS groups: adrenal adenoma + DST cortisol \\>1.8 µg\u002FdL + no overt Cushing + eligible for adrenalectomy\n* Willingness to postpone surgery 6 months if randomized\n* Controls: no adrenal abnormalities + normal DST + BMI ≥27 + ≥2 cardiometabolic conditions\n* Stable medication doses for ≥4 weeks\n* Negative pregnancy test if applicable\n\nExclusion Criteria:\n\n* Prior GLP-1 RA within 90 days\n* Weight change \\>5 kg in past 90 days\n* Prior obesity\u002Fdiabetes surgery\n* Type 1 diabetes or other diabetes types\n* Severe organ disease\n* Recent pancreatitis\n* Pregnancy, breastfeeding\n* Contraindication to semaglutide\n* Contraindication to surgery delay\n* Chronic glucocorticoid use","ALL","18 Years",{"count":78,"type":79},75,"ESTIMATED","INTERVENTIONAL",[82],"NA","The goal of this study is to learn how two treatments-adrenalectomy (surgical removal of an adrenal gland) and semaglutide (a medication used for weight management)-affect insulin resistance and cortisol regulation in adults with mild autonomous cortisol secretion (MACS). The study will also learn how these treatments impact body composition, blood pressure, cholesterol, inflammation, muscle strength, and quality of life.\n\nThe main questions the study aims to answer are:\n\n1. Does adrenalectomy or semaglutide improve insulin resistance more in people with MACS?\n2. How do these treatments change cortisol patterns and other cardiometabolic risk factors?\n3. Do people with MACS respond differently to semaglutide compared to matched adults without MACS?\n\nParticipants will:\n\n1. Receive either adrenalectomy or semaglutide if they have MACS, or semaglutide if they are matched controls\n2. Complete clinic visits and phone visits over about 26-30 weeks\n3. Undergo metabolic testing such as blood tests, urine steroid profiling, body composition scans, blood pressure monitoring, muscle strength testing, and questionnaires about health and well-being",[85,86,87,88],"Mild Autonomous Cortisol Secretion (MACS)","Autonomous Cortisol Secretion (ACS)","Subclinical Cushing's","Mild Autonomous Cortisol Excess",[90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107],"Mild Autonomous Cortisol Secretion","MACS","Adrenal incidentaloma","Adrenal adenoma","Subclinical Cushing","Hypercortisolism","Cortisol dysregulation","Adrenalectomy","Semaglutide","Weight loss","Body composition","Insulin resistance","GLP-1 receptor agonist","Hyperinsulinemic-euglycemic clamp","Cortisol dynamics","Visceral fat","cardiometabolic risk","randomized controlled trial","2026-03-25",{"date":110,"type":111},"2026-03-27","ACTUAL",{"date":113,"type":111},"2026-03-05",{"date":115,"type":79},"2030-05-31",{"name":5,"class":6},1]