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. 2025 Feb;48(2):519-528.
doi: 10.1038/s41440-024-01933-y. Epub 2024 Oct 14.

Myosteatosis and sarcopenia are linked to autonomous cortisol secretion in patients with aldosterone-producing adenomas

Bo-Ching Lee  1 , Yu-Ling Chang  1 , Po-Ting Chen  1 , Li-Wen Liu  1 , Kao-Lang Liu  1 , Chin-Chen Chang  2   3 , Vin-Cent Wu  4 , Yen-Hung Lin  4 ; TAIPAI Study Group
Collaborators, Affiliations

Myosteatosis and sarcopenia are linked to autonomous cortisol secretion in patients with aldosterone-producing adenomas

Bo-Ching Lee et al. Hypertens Res. 2025 Feb.

Abstract

Patients with adrenal aldosterone-producing adenomas (APA) face elevated cardiovascular risks, especially when cortisol is co-secreted, yet the impact on muscle health remains unclear. Myosteatosis, characterized by fatty infiltration into muscles, is linked to cardiometabolic diseases and decreased survival. We aimed to investigate the association between autonomous cortisol secretion (ACS) in APA and muscle quantity and quality. In this study, we analyzed data from 228 APA patients undergoing laparoscopic adrenalectomy between 2009 and 2024, assessing muscle composition via computed tomography. Intermuscular adipose tissue (IMAT), skeletal muscle area and density, visceral and subcutaneous adipose tissue area at L3 were measured. Comparisons were made between ACS and non-ACS groups. We found that among 228 patients, 76 (33.3%) had ACS. Those with ACS exhibited significantly higher IMAT area (P = 0.042) and lower skeletal muscle area (P = 0.002) and density (P < 0.001). Multivariable regression confirmed ACS positively associated with IMAT area and negatively associated with skeletal muscle area and density. At 1-year follow-up, ACS patients (n = 15) experienced decreased IMAT area (P = 0.001) and increased skeletal muscle area (P = 0.031) post-adrenalectomy, while those without ACS (n = 29) showed no IMAT change but increased visceral (P < 0.001) and subcutaneous (P = 0.008) adipose tissue area. In summary, myosteatosis and sarcopenia are linked to ACS in APA patients, and these parameters improve following adrenalectomy.

Keywords: Autonomous cortisol secretion; Body composition; Glucocorticoids; Hyperaldosteronism; Myosteatosis; Sarcopenia.

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Conflict of interest statement

Compliance with ethical standards. Conflict of interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Schematic of abdominal compartments segmentation using semi-automatic software. The A cross-sectional computerized tomography image at the mid L3 vertebral level is quantified based on different densities of B subcutaneous adipose tissue (red), visceral adipose tissue (green), skeletal muscle (yellow), and intermuscular adipose tissue (light blue)
Fig. 2
Fig. 2
Associations of the body composition parameters with post-DST serum cortisol levels in patients with APA. The scatter plots illustrate the relationships between IMAT A, SMA B and SMD C and post-DST serum cortisol levels. APA aldosterone-producing adenoma, DST dexamethasone suppression test, IMAT intermuscular adipose tissue, SMA skeletal muscle area, SMD skeletal muscle density
See this image and copyright information in PMC

Comment in

References

    1. Chang YY, Tsai CH, Peng SY, Chen ZW, Chang CC, Lee BC, et al. KCNJ5 somatic mutations in aldosterone-producing adenoma are associated with a worse baseline status and better recovery of left ventricular remodeling and diastolic function. Hypertension. 2021;77:114–25. - PubMed
    1. Bleier J, Shlomai G, Fishman B, Dotan Z, Rosenzweig B, Tirosh A. The quantitative relationship between autonomous cortisol secretion, dysglycemia and the metabolic syndrome. Endocr Pract. 2020;26:974–82. - PubMed
    1. Nakajima Y, Yamada M, Taguchi R, Satoh T, Hashimoto K, Ozawa A, et al. Cardiovascular complications of patients with aldosteronism associated with autonomous cortisol secretion. J Clin Endocrinol Metab. 2011;96:2512–8. - PubMed
    1. Khan U. Nonfunctioning and subclinical cortisol secreting adrenal incidentalomas and their association with metabolic syndrome: a systematic review. Indian J Endocrinol Metab. 2019;23:332–46. - PMC - PubMed
    1. Debono M, Prema A, Hughes TJ, Bull M, Ross RJ, Newell-Price J. Visceral fat accumulation and postdexamethasone serum cortisol levels in patients with adrenal incidentaloma. J Clin Endocrinol Metab. 2013;98:2383–91. - PubMed

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