Objective

Increased visceral fat and sarcopenia are cardiovascular risk factors that may explain increased cardiovascular morbidity and frailty in patients with adrenal adenomas. Our objective was to compare body composition measurement of patients with adrenal adenomas to referent subjects without adrenal disease.

Design

Cross-sectional study, 2014–2018.

Methods

Participants were adults with nonfunctioning adrenal tumor (NFAT), mild autonomous cortisol secretion (MACS), and Cushing syndrome (CS) and age, sex, and BMI 1:1 matched referent subjects without adrenal disorders. Main outcome measures were body composition measurements calculated from abdominal CT imaging. Intra-abdominal adipose tissue and muscle mass measurements were performed at the third lumbar spine level.

Results

Of 227 patients with adrenal adenomas, 20 were diagnosed with CS, 76 with MACS, and 131 with NFAT. Median age was 56 years (range: 18–89), and 67% were women. When compared 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, visceral fat/muscle area ratio increased by 2.3 (P = 0.02) and mean total skeletal muscle area decreased by 2.2 cm² (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 NFAT. Even a subtle abnormality in cortisol secretion may impact health of patients with adenomas.

中文翻译：

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肾上腺腺瘤患者的身体成分异常

客观的

内脏脂肪增加和肌肉减少症是心血管危险因素，可以解释肾上腺腺瘤患者心血管发病率和虚弱程度的增加。我们的目标是比较肾上腺腺瘤患者与没有肾上腺疾病的参考对象的身体成分测量。

设计

横断面研究，2014-2018 年。

方法

参与者是患有非功能性肾上腺肿瘤 (NFAT)、轻度自主皮质醇分泌 (MACS) 和库欣综合征 (CS) 的成年人，以及年龄、性别和 BMI 1:1 匹配的没有肾上腺疾病的参考对象。主要结果测量是从腹部 CT 成像计算的身体成分测量值。在第三腰椎水平进行腹内脂肪组织和肌肉质量测量。

结果

在 227 例肾上腺腺瘤患者中，20 例被诊断为 CS，76 例为 MACS，131 例为 NFAT。中位年龄为 56 岁（范围：18-89），67% 为女性。与参照对象相比，患有 CS、MACS 和 NFAT 的患者表现出更高的内脏脂肪（优势比 (OR)：2.2（95% CI：0.9-6.5）、2.0（1.3-3.2）和 1.8（1.2-2.7） ) 和较低的骨骼肌面积 (OR: 0.01 (95% CI: 0–0.09), 0.31 (0.18–0.49), 和 0.3 (1.2–2.7))。对于隔夜地塞米松后皮质醇每增加 1 µg/dL，内脏脂肪/肌肉面积比增加了 2.3 ( P = 0.02)，平均总骨骼肌面积减少了 2.2 cm ² ( P = 0.03)。

结论

与包括 NFAT 患者在内的参照对象相比，肾上腺腺瘤患者表现出较低的肌肉质量和较高比例的内脏脂肪。即使是皮质醇分泌的细微异常也可能影响腺瘤患者的健康。