Impact of hypercortisolism on skeletal muscle mass and adipose tissue mass in patients with adrenal adenomas

Delivanis, Danae A.; Iñiguez-Ariza, Nicole M.; Zeb, Muhammad H.; Moynagh, Michael R.; Takahashi, Naoki; McKenzie, Travis J.; Thomas, Melinda; Gogos, Charalambos; Young, William F.; Bancos, Irina; Kyriazopoulou, Venetsana

doi:10.1111/cen.13512

Cited by 49 publications

(53 citation statements)

References 45 publications

(75 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lower skeletal SMD determined by CT is indicative of ectopic fat accumulation in skeletal muscle in the form of intramyocellular lipid droplets (myosteatosis) . In this study, we found that patients with overt CS or MACE had lower skeletal muscle area compared to NFAT at baseline, in agreement with previous studies . Of note, SMD values also decreased in a stepwise fashion from NFAT to MACE to overt CS.…”

Section: Discussionsupporting

confidence: 91%

“…SFA was also reduced in patients with overt CS or MACE but to a lesser extent with the decrease of VSR in both groups, which supports the known preferential impact of cortisol excess on visceral fat depots . Unlike for overt CS, the difference in VFA between NFAT and MACE was not clear in previous studies . In line with these findings, we found no significant difference in baseline VFA between patients with MACE and NFAT.…”

Section: Discussionsupporting

confidence: 87%

“…Given that we analysed patients from adrenalectomy cohort, possibility of selection bias cannot be ruled out. Because we could not measure the duration of exposure to cortisol excess in patients with MACE, cumulative effects of cortisol excess on disease severity can vary among individuals with MACE, as speculated in a prior study with similar results . However, the significant decrease in VFA shown in the MACE group after adrenalectomy in this study contrasted with the continued accumulation of visceral fat observed in other studies in patients with MACE who did not undergo surgery .…”

Section: Discussioncontrasting

confidence: 52%

“…Approximately 42%‐83% of patients with overt CS are reported to experience proximal muscle atrophy and weakness . Previous cross‐sectional studies mainly focused on the association of hypercortisolism with low muscle mass . However, data on changes in SMD values, as a marker of muscle quality, have been limited.…”

Section: Discussionmentioning

confidence: 99%

“…Changes in body composition, including accumulation of visceral fat and progressive loss of skeletal muscle, are the hallmark of chronic hypercortisolism . Debono and Delivanis demonstrated that the severity of hypercortisolism was associated with higher computed tomography (CT)‐determined visceral fat mass and lower trunk skeletal muscle mass in patients with adrenal adenomas . Yener reported CT‐measured visceral fat area (VFA) accumulation during a 3‐year follow‐up in patients with MACE .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Changes of computed tomography‐based body composition after adrenalectomy in patients with endogenous hypercortisolism

Hong

Lee

et al. 2018

Clinical Endocrinology

View full text Add to dashboard Cite

Summary Context Data on longitudinal changes of computed tomography (CT)‐determined visceral fat area (VFA), skeletal muscle area (SMA) and skeletal muscle radiodensity (SMD) after adrenalectomy are limited in patients with hypercortisolism. Objective To examine the association of severity of cortisol excess and improvement of CT‐based muscle and fat parameters after adrenalectomy. Design Retrospective observational cohort study. Patients One hundred thirty‐four patients with overt Cushing's syndrome (CS; n = 39), mild autonomous cortisol excess (MACE; n = 57), or nonfunctioning adrenal tumour (NFAT; n = 38) at a tertiary endocrinology institution between 2006 and 2017 were included. Measurements Changes in CT‐determined VFA, visceral‐to‐subcutaneous fat ratio (VSR), SMA, skeletal muscle index (SMI), and SMD measured at the third lumbar vertebra (L3). Results At baseline, CS patients had higher VFA, lower SMA, SMI and SMD values, compared to NFAT or MACE patients. Compared to NFAT, significant decreases in VFA and increases in SMA, SMI and SMD was observed in CS 1 year after adrenalectomy. In MACE, adjusted mean changes of SMD but not VFA, SMA or SMI differ significantly compared to NFAT (+8.9% vs −3.4%, P = 0.032). In a multivariate linear regression model, the increase by 1 μg/dL of post‐dexamethasone serum cortisol at baseline was independently associated with greater reduction of VFA (−3.95%), VSR (−3.07%), and increase in SMD (+0.92%, P < 0.05 for all) after adrenalectomy. Conclusions The severity of cortisol excess was associated with greater improvement of L3 VFA, VSR and SMD 1 year after adrenalectomy. These CT‐based markers may allow more objective assessment of treatment benefit at earlier stage.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Changes of computed tomography‐based body composition after adrenalectomy in patients with endogenous hypercortisolism

Hong

Lee

et al. 2018

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

Fat compartments in patients with depression: A meta‐analysis

Cosan

Schweiger²,

Kahl

et al. 2020

Brain and Behavior

View full text Add to dashboard Cite

Introduction Depressive disorders are a common illness worldwide. Major depression is known as a significant predictor of the metabolic syndrome. However, the effects of depression on adipose tissue compartments are controversial. This meta‐analysis aimed to evaluate the state of research on the relationship between patients with depression and adipose tissue compartments as compared to nondepressed individuals. Methods The PubMed database was searched for human studies that measured adipose tissue compartments such as visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and/or organ‐specific adipose tissue measurements using dual‐energy X‐ray absorptiometry, magnetic resonance imaging or computed tomography scan and reported the means and a measure of variance separately for depressed individuals and healthy controls. Twelve articles were identified, including a total of 1,141 depressed and 2,545 nondepressed individuals. Results Major depressive disorder and self‐reported depressive symptoms were associated with elevated visceral adipose tissue and elevated subcutaneous adipose tissue. Subanalyses for gender, age, method of adipose tissue measurement, and method of depression assessment showed elevated visceral adipose in depressed individuals. The results could be replicated when focussing on studies controlling for body mass index (BMI). Regarding other adipose tissue compartments, meta‐analysis could not be carried out due to lack of studies. Conclusions Depression is associated with enlarged visceral and subcutaneous adipose tissue. Further, especially longitudinal, research is needed to identify the mechanism through which depressive disorders contribute to visceral adiposity.

show abstract

Modern Management of Mild Autonomous Cortisol Secretion

Delivanis

Athimulam

Bancos

2019

Clin Pharma and Therapeutics

Self Cite

View full text Add to dashboard Cite

Incidentally discovered adrenal tumors are reported in ~ 5% of adults undergoing cross-sectional imaging. Mild autonomous cortisol secretion (MACS) from the adrenal mass is demonstrated in 5-48% of patients with adrenal tumors. The diagnosis of MACS represents a challenge due to limitations of the currently used diagnostic tests, differences in the definitions of the clinically relevant MACS, and heterogeneity in an individual's susceptibility to abnormal cortisol secretion from the adrenal mass. Patients with MACS present with increased risk of cardiovascular risk factors, cardiovascular events, metabolic bone disease, and mortality. Adrenalectomy improves or reverses MACS-associated comorbidities in selected patients. The current review will address diagnostic and management challenges in the care of patients with MACS, discuss data on emerging biomarkers, and suggest future directions in the field of MACS.

show abstract

Impact of hypercortisolism on skeletal muscle mass and adipose tissue mass in patients with adrenal adenomas

Abstract: 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.

Cited by 49 publications

References 45 publications

Changes of computed tomography‐based body composition after adrenalectomy in patients with endogenous hypercortisolism

Changes of computed tomography‐based body composition after adrenalectomy in patients with endogenous hypercortisolism

Fat compartments in patients with depression: A meta‐analysis

Modern Management of Mild Autonomous Cortisol Secretion

Contact Info

Product

Resources

About