Adrenomedullary function, obesity and permissive influences of catecholamines on body mass in patients with chromaffin cell tumours

An, Yingli; Reimann, Manja; Masjkur, Jimmy; Langton, Katharina; Peitzsch, Mirko; Deutschbein, Timo; Fassnacht, Martin; Rogowski-Lehmann, Natalie; Beuschlein, Felix; Fliedner, Stephanie; Stell, Anthony; Prejbisz, Aleksander; Januszewicz, Andrzej; Lenders, Jacques W.M.; Bornstein, Stefan R.; Eisenhofer, Graeme

doi:10.1038/s41366-018-0054-9

Cited by 16 publications

(16 citation statements)

References 56 publications

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“…Also important are the findings derived from multivariate analyses showing that the lower BPs in patients with than without PPGLs lost significance after correction for age, sex and specially the lower BMI in patients with than without PPGLs. Significant impacts of catecholamine-producing tumors on body weight, adiposity and energy metabolism are well documented (25)(26)(27), with differences in BMI reflecting differences in catecholamines (28). Here we show that among patients tested for PPGLs, those with a BMI lower than 25 kg/m 2 have a higher prevalence compared to a lower prevalence of PPGLs in obese patients.…”

Section: Discussionmentioning

confidence: 53%

Pheochromocytoma and paraganglioma: clinical feature-based disease probability in relation to catecholamine biochemistry and reason for disease suspicion

Geroula

Deutschbein

Langton

et al. 2019

European Journal of Endocrinology

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Objective Hypertension and symptoms of catecholamine excess are features of pheochromocytomas and paragangliomas (PPGLs). This prospective observational cohort study assessed whether differences in presenting features in patients tested for PPGLs might assist establishing likelihood of disease. Design and methods Patients were tested for PPGLs because of signs and symptoms, an incidental mass on imaging or routine surveillance due to previous history or hereditary risk. Patients with (n = 245) compared to without (n = 1820) PPGLs were identified on follow-up. Differences in presenting features were then examined to assess the probability of disease and relationships to catecholamine excess. Results Hyperhidrosis, palpitations, pallor, tremor and nausea were 30–90% more prevalent (P < 0.001) among patients with than without PPGLs, whereas headache, flushing and other symptoms showed little or no differences. Although heart rates were higher (P < 0.0001) in patients with than without PPGLs, blood pressures were not higher and were positively correlated to BMI, which was lower (P < 0.0001) in patients with than without PPGLs. From these differences in clinical features, a score system was established that indicated a 5.8-fold higher probability of PPGLs in patients with high than low scores. Higher scores among patients with PPGLs were associated, independently of tumor size, with higher biochemical indices of catecholamine excess. Conclusions This study identifies a complex of five signs and symptoms combined with lower BMI and elevated heart rate as key features in patients with PPGLs. Prevalences of these features, which reflect variable tumoral catecholamine production, may be used to triage patients according to likelihood of disease.

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Section: Discussionmentioning

confidence: 53%

Pheochromocytoma and paraganglioma: clinical feature-based disease probability in relation to catecholamine biochemistry and reason for disease suspicion

Geroula

Deutschbein

Langton

et al. 2019

European Journal of Endocrinology

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“…However, the correlation of weight change with urine norepinephrine or plasma normetanephrine could not be solidified in this study. Further, in a recent study by An and colleagues [54], the preoperative urinary total catecholamine levels of 210 PPGL patients were negatively correlated with preoperative body mass index (BMI) and further positively correlated with the postoperative change in BMI. In contrast, no correlation between weight change and plasma norepinephrine levels before and after surgery were found in a different cohort of 42 PPGL patients [50].…”

Section: Ppgl and Body Weight And Body Compositionmentioning

confidence: 93%

Metabolic Alterations in Patients with Pheochromocytoma

Erlic

Beuschlein

2018

Exp Clin Endocrinol Diabetes

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Metabolic alterations in patients with hormonally active pheochromocytoma/paraganglioma (PPGL) have been described early on in the literature. The initial findings were related to disturbed glucose homeostasis and lipolysis activation, as well as elevated metabolic rates in affected patients. Similarly, from early autopsy reports, the presence of brown adipose tissue had been noted in PPGL patients. In more recent years, changes in body weight, fat mass and distribution have been analyzed in more detail in addition to activity of brown adipose tissue based on functional imaging techniques. Over the last decades, several larger case series and cohort studies have contributed towards the elucidation of possible mechanism contributing to these clinical observations. Herein, we summarize the clinical and experimental data regarding metabolic alterations and related clinical manifestations in PPGL patients.

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“…The study showed significant associations between the 24 h urine fractionated nephrines excretion and some metabolic disturbances in obese women. Several studies have shown interrelations between catecholamines and obesity [ 6 , 8 , 9 , 10 ]. A large study of Chinese men and women showed that gradual weight gain was accompanied by an increase of urinary norepinephrine secretion and a decrease of urine epinephrine secretion [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the role of catecholamines is poorly investigated in patients with metabolic syndrome, prediabetes, and diabetes. Several studies have investigated the relationships between catecholamines and obesity but definitive conclusions are still lacking [ 4 , 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Multivariate Statistical Approach for Nephrines in Women with Obesity

et al. 2021

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Catecholamines are physiological regulators of carbohydrate and lipid metabolism during stress, but their chronic influence on metabolic changes in obese patients is still not clarified. The present study aimed to establish the associations between the catecholamine metabolites and metabolic syndrome (MS) components in obese women as well as to reveal the possible hidden subgroups of patients through hierarchical cluster analysis and principal component analysis. The 24-h urine excretion of metanephrine and normetanephrine was investigated in 150 obese women (54 non diabetic without MS, 70 non-diabetic with MS and 26 with type 2 diabetes). The interrelations between carbohydrate disturbances, metabolic syndrome components and stress response hormones were studied. Exploratory data analysis was used to determine different patterns of similarities among the patients. Normetanephrine concentrations were significantly increased in postmenopausal patients and in women with morbid obesity, type 2 diabetes, and hypertension but not with prediabetes. Both metanephrine and normetanephrine levels were positively associated with glucose concentrations one hour after glucose load irrespectively of the insulin levels. The exploratory data analysis showed different risk subgroups among the investigated obese women. The development of predictive tools that include not only traditional metabolic risk factors, but also markers of stress response systems might help for specific risk estimation in obesity patients.

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Adrenomedullary function, obesity and permissive influences of catecholamines on body mass in patients with chromaffin cell tumours

Abstract: The findings in patients with PPGL support an influence of high circulating catecholamines on body weight. Additional associations of adrenomedullary dysfunction with obesity raise the possibility of a permissive influence of the adrenal medulla on the regulation of body weight.

Cited by 16 publications

References 56 publications

Pheochromocytoma and paraganglioma: clinical feature-based disease probability in relation to catecholamine biochemistry and reason for disease suspicion

Pheochromocytoma and paraganglioma: clinical feature-based disease probability in relation to catecholamine biochemistry and reason for disease suspicion

Metabolic Alterations in Patients with Pheochromocytoma

Multivariate Statistical Approach for Nephrines in Women with Obesity

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