Effect of mild cortisol cosecretion on body composition and metabolic parameters in patients with primary hyperaldosteronism
© 2023 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd..
OBJECTIVE: To investigate the effects of simultaneous cortisol cosecretion (CCS) on body composition in computed tomography (CT)-imaging and metabolic parameters in patients with primary aldosteronism (PA) with the objective of facilitating early detection.
DESIGN: Retrospective cohort study.
PATIENTS: Forty-seven patients with PA and CCS confirmed by 1-mg dexamethasone suppression test (DST) with a cutoff of ≥1.8 µg/dL were compared with PA patients with excluded CCS (non-CCS, n = 47) matched by age and sex.
METHODS: Segmentation of the fat compartments and muscle area at the third lumbar region was performed on non-contrast-enhanced CT images with dedicated segmentation software. Additionally, liver, spleen, pancreas and muscle attenuation were compared between the two groups.
RESULTS: Mean cortisol after DST was 1.2 µg/dL (33.1 nmol/L) in the non-CCS group and 3.2 µg/dL (88.3 nmol/L) in the CCS group with mild autonomous cortisol excess (MACE). No difference in total, visceral and subcutaneous fat volumes was observed between the CCS and non-CCS group (p = .7, .6 and .8, respectively). However, a multivariable regression analysis revealed a significant correlation between total serum cholesterol and results of serum cortisol after 1-mg DST (p = .026). Classification of the patients based on visible lesion on CT and PA-lateralization via adrenal venous sampling also did not show any significant differences in body composition.
CONCLUSION: MACE in PA patients does not translate into body composition changes on CT-imaging. Therefore, early detection of concurrent CCS in PA is currently only attainable through biochemical tests. Further investigation of the long-term clinical adverse effects of MACE in PA is necessary.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:100 |
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| Enthalten in: |
Clinical endocrinology - 100(2024), 3 vom: 02. März, Seite 212-220 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mansour, Nabeel [VerfasserIn] |
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| Links: |
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| Themen: |
Body composition |
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| Anmerkungen: |
Date Completed 06.02.2024 Date Revised 05.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/cen.15013 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366546511 |
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| 245 | 1 | 0 | |a Effect of mild cortisol cosecretion on body composition and metabolic parameters in patients with primary hyperaldosteronism |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVE: To investigate the effects of simultaneous cortisol cosecretion (CCS) on body composition in computed tomography (CT)-imaging and metabolic parameters in patients with primary aldosteronism (PA) with the objective of facilitating early detection | ||
| 520 | |a DESIGN: Retrospective cohort study | ||
| 520 | |a PATIENTS: Forty-seven patients with PA and CCS confirmed by 1-mg dexamethasone suppression test (DST) with a cutoff of ≥1.8 µg/dL were compared with PA patients with excluded CCS (non-CCS, n = 47) matched by age and sex | ||
| 520 | |a METHODS: Segmentation of the fat compartments and muscle area at the third lumbar region was performed on non-contrast-enhanced CT images with dedicated segmentation software. Additionally, liver, spleen, pancreas and muscle attenuation were compared between the two groups | ||
| 520 | |a RESULTS: Mean cortisol after DST was 1.2 µg/dL (33.1 nmol/L) in the non-CCS group and 3.2 µg/dL (88.3 nmol/L) in the CCS group with mild autonomous cortisol excess (MACE). No difference in total, visceral and subcutaneous fat volumes was observed between the CCS and non-CCS group (p = .7, .6 and .8, respectively). However, a multivariable regression analysis revealed a significant correlation between total serum cholesterol and results of serum cortisol after 1-mg DST (p = .026). Classification of the patients based on visible lesion on CT and PA-lateralization via adrenal venous sampling also did not show any significant differences in body composition | ||
| 520 | |a CONCLUSION: MACE in PA patients does not translate into body composition changes on CT-imaging. Therefore, early detection of concurrent CCS in PA is currently only attainable through biochemical tests. Further investigation of the long-term clinical adverse effects of MACE in PA is necessary | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Kürzinger, Lydia |e verfasserin |4 aut | |
| 700 | 1 | |a Adolf, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Walter, Roman |e verfasserin |4 aut | |
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| 700 | 1 | |a Heinrich, Daniel |e verfasserin |4 aut | |
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