Endocrine Abstracts

Introduction: Cortisol has important roles in the regulation of body composition and hypercortisolaemia have major impact on body fat distribution. The aim of this study was to analyze differences in adipose tissue distribution in women with Cushing’s disease and Cushing’s syndrome due to adrenal adenoma.

Method: We evaluated 12 women with Cushing’s syndrome, six with ACTH secreting pituitary adenomas (Group A) and six with adrenal adenomas (Group B). In all subjects BMI was calculated and body composition assessed by dual energy X-ray absorptiometry. Basal values of serum cortisol, ACTH and DHEA-S were determined at admission to the hospital.

Results: Mean age was comparable between Group A and Group B (44.5+/−14.7 years vs. 52.7+/−5.6 years, P=0.23) while BMI was significantly higher in Group B (32.7+/−5.5 kg/m² vs. 25.6+/−4.3 kg/m², P=0.034). Group B had significantly higher percent of total body fat (45.4+/−4.3% vs. 34.5+/−8.4%, P=0.021) but borderline difference in trunk fat percentage (Group B 44.3+/−6.8% vs. Group A 32.6+/−10.7%, P=0.055). Main difference in adipose tissue percentage was found on arms and legs, which was higher in Group B (arms 53.6+/−8.8% vs. 38.5+/−11.9%, P=0.037; legs 47.6+/−4.4% vs. 39.0+/−5.9%, P=0.022). There was no significant difference in lean body mass or bone mineral density between these two groups. As expected, ACTH was significantly higher in group A (74.3+/−16.4 ng/l vs. 14.7+/−7.6 ng/l, P=0.040), but with no significant differences in morning cortisol concentrations (Group A 664.2+/−210.4 nmol/l vs. Group B 432.8+/−146 nmol/l, P=0.060), midnight cortisol concentrations (Group A 461.3+/−236.2 nmol/l vs. Group B 330.3+/−203.6 nmol/l, P=0.410) or DHEA-S concentrations (4.9+/−5.4 nmol/l vs. 2.8+/−3.8 nmol/l, P=0.564) between groups.

Conclusion: Our group of women with Cushing’s syndrome due to adrenal adenoma had higher BMI and increased total fat adiposity. It was not determined yet if the origin of hypercortisolism, or derangements in other related hormones or metabolic pathways, could possibly influence body composition in those patients.