Abnormal body composition in patients with adrenal adenomas

Objective: Increased visceral fat and sarcopenia are cardiovascular risk f actors that may explain increased cardiovascular morbidity and frailty in patients with adrenal a denomas. Our objective was to compare body composition measurement of patients with adrenal adenomas to re ferent subjects without adrenal disease. Design: Cross-sectional study, 2014-2018. Methods: Participants were adults with nonfunctioning adrenal tumor (NFA T), mild autonomous cortisol secretion (MACS), and Cushing syndrome (CS) and age, sex, and BMI 1:1 mat ched referent subjects without adrenal disorders. Main outcome measures were body composition measurements calcul ated from abdominal CT imaging. Intra-abdominal adipose tissue and muscle mass measurements were perf ormed at the third lumbar spine level. Results: Of 227 patients with adrenal adenomas, 20 were diagnosed with C S, 76 with MACS, and 131 with NFAT. Median age was 56 years (range: 18-89), and 67% were women. When compa red to referent subjects, patients with CS, MACS, and NFAT demonstrated a higher visceral fat (odds ratio (OR): 2 .2 (95% CI: 0.9-6.5), 2.0 (1.3-3.2), and 1.8 (1.2-2.7) and a lower skeletal muscle area (OR: 0.01 (95% CI: 0-0.09), 0.31 (0. 18-0.49), and 0.3 (1.2-2.7)) respectively. For every 1 μg/dL cortisol increase after overnight dexamethasone, viscer al fat/muscle area ratio increased by 2.3 ( P = 0.02) and mean total skeletal muscle area decreased by 2.2 cm 2 (P = 0.03). Conclusion: Patients with adrenal adenomas demonstrate a lower muscle mass and a higher proportion of visceral fat when compared to referent subjects, including patients with NFA T. Even a subtle abnormality in cortisol secretion may impact health of patients with adenomas. 2021 European Society of Endocrinology Printed in Great Britain.