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

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

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


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's syndrome (CS), 48 patients with mild autonomous cortisol excess (MACE) and 32 patients with a nonfunctioning adrenal tumour (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 <.001) and by 0.3 (P <.001); however, these measurements were decreased by 0.04 (P =.007) and 0.2 (P =.01), respectively, in patients with MACE. Total muscle mass was decreased by −10 cm2 (P =.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 28 nmol/L cortisol increase there was a 0.008 increase in V/T (P <.001), 0.02 increase in the V/S fat ratio (P <.001) and a 1.2 cm2 decrease in mean total muscle mass (P =.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.

Original languageEnglish (US)
Pages (from-to)209-216
Number of pages8
JournalClinical Endocrinology
Issue number2
StatePublished - Feb 2018


  • Cushing's syndrome
  • cardiovascular risk
  • hypercortisolemia
  • subcutaneous fat
  • visceral fat

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


Dive into the research topics of 'Impact of hypercortisolism on skeletal muscle mass and adipose tissue mass in patients with adrenal adenomas'. Together they form a unique fingerprint.

Cite this