Patients with adrenal adenomas and autonomous cortisol secretion. Impact of hypercortisolism on skeletal and adipose tissue mass, measured in abdominal computed tomography

• Κύριος συγγραφέας: Δεληβάνη, Δανάη
• Άλλοι συγγραφείς: Κυριαζοπούλου, Βενετσάνα
• Μορφή: Thesis
• Γλώσσα: English
• Έκδοση: 2019
• Θέματα: Hypercortisolemia; Adrenal adenomas; Adipose tissue; Muscle mass; Υπερκορτιζολαιμία; Αδένωμα επινεφριδίων; Λιπώδης ιστός; Μυικός ιστός

Context: Abdominal visceral adiposity and central sarcopenia are markers of increased cardiovascular risk and mortality. Objective: To assess whether central sarcopenia and adiposity can serve as a marker of disease severity in patients with adrenal adenomas and glucocorticoid secretory autonomy. Design: Retrospective cohort study Patients: Twenty-five patients with overt Cushing syndrome (CS), 48 patients with mild autonomous cortisol excess (MACE), and 32 patients with a non-functioning adrenal tumor (NFAT) were included. Methods: Medical records were reviewed and body composition measurements (visceral fat [VAT], subcutaneous fat [SAT], visceral/total fat [V/T], visceral/subcutaneous [V/S] and total abdominal muscle mass) were calculated based on abdominal computed tomography (CT). Results: In patients with overt CS, when compared to patients with NFAT, the V/T fat and the V/S ratio were increased by 0.08 (P<0.001) and by 0.3 (P<0.001); however, these measurements were decreased by 0.04 (P=0.007) and 0.2 (P=0.01), respectively in patients with MACE. Total muscle mass was decreased by -10 cm2 (P =0.02) in patients with overt CS compared to patients with NFAT.Correlation with morning serum cortisol concentrations after dexamethasone suppression testing revealed that for every 28nmol/L cortisol increase there was a 0.008 increase in V/T (P<0.001), 0.02 increase in the V/S fat ratio (P<0.001), and a 1.2 cm2 decrease in mean total muscle mass (P=0.002). Conclusions: The severity of hypercortisolism was correlated with lower muscle mass and higher visceral adiposity. These CT-based markers may allow for a more reliable and objective assessment of glucocorticoid-related disease severity in patients with adrenal adenomas.