AKT1 and Cushing syndrome due to macronodular adrenal hyperplasia: Metabolic pathway enrichment analysis results of differential metabolites between HPW and HNPW groups showed that in positive ion mode (Figure 4J), 27 enriched metabolic pathways were significantly different between the two groups; the top three metabolic pathways with the largest differences between the two groups were PI3K-Akt and mTOR signaling pathways, cortisol synthesis and secretion, and Cushing syndrome.