Abnormal body composition in patients with adrenal adenomas

Danae A. Delivanis, Maria D.Hurtado Andrade, Tiffany Cortes, Shobana Athimulam, Aakanksha Khanna, Elizabeth Atkinson, Travis McKenzie, Naoki Takahashi, Michael R. Moynagh, Irina Bancos

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)653-662
Number of pages10
JournalEuropean Journal of Endocrinology
Volume185
Issue number5
DOIs
StatePublished - Nov 2021

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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