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Title: Patients with adrenal adenomas and autonomous cortisol secretion. Impact of hypercortisolism on skeletal and adipose tissue mass, measured in abdominal computed tomography
Other Titles: Ασθενείς με αδένωμα επινεφριδίου και αυτόνομη έκκριση κορτιζόλης. Μελέτη του μυ και λιπώδους ιστού με αξονική τομογραφία και συσχέτιση των ευρημάτων με την αυτόνομη υπερκορτιζολαιμία και συνοδά νοσήματα
Authors: Δεληβάνη, Δανάη
Keywords: Hypercortisolemia
Adrenal adenomas
Adipose tissue
Muscle mass
Keywords (translated): Υπερκορτιζολαιμία
Αδένωμα επινεφριδίων
Λιπώδης ιστός
Μυικός ιστός
Abstract: 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.
Abstract (translated): Κεντρική παχυσαρκία και σαρκοπενία είναι δυο δείκτες ένδειξης αυξημένου καρδιαγγειακου κινδύνου. Σκοπός της εργασιας αυτης ειναι να μελετησουμε αν οι μετρήσεις μυικής μαζας και λιπώδους ιστού μπορουν να χρησιμοποιηθούν ως δείκτες αυξημενου καρδιαγγειακου κινδύνου σε ασθενείς με αδενώματα των επινεφριδιων και αυτόνομη εκκριση κορτιζολης.
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