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Trandafir AI, Ghemigian A, Ciobica ML, Nistor C, Gurzun MM, Nistor TVI, Petrova E, Carsote M. Diabetes Mellitus in Non-Functioning Adrenal Incidentalomas: Analysis of the Mild Autonomous Cortisol Secretion (MACS) Impact on Glucose Profile. Biomedicines 2024; 12:1606. [PMID: 39062179 PMCID: PMC11274780 DOI: 10.3390/biomedicines12071606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Non-functioning adrenal incidentalomas (NFAIs) have been placed in relationship with a higher risk of glucose profile anomalies, while the full-blown typical picture of Cushing's syndrome (CS) and associated secondary (glucocorticoid-induced) diabetes mellitus is not explicitly confirmed in this instance. Our objective was to highlight the most recent data concerning the glucose profile, particularly, type 2 diabetes mellitus (T2DM) in NFAIs with/without mild autonomous cortisol secretion (MACS). This was a comprehensive review of the literature; the search was conducted according to various combinations of key terms. We included English-published, original studies across a 5-year window of publication time (from January 2020 until 1 April 2024) on PubMed. We excluded case reports, reviews, studies on T1DM or secondary diabetes, and experimental data. We identified 37 studies of various designs (14 retrospective studies as well 13 cross-sectional, 4 cohorts, 3 prospective, and 2 case-control studies) that analysed 17,391 individuals, with a female-to-male ratio of 1.47 (aged between 14 and 96 years). T2DM prevalence in MACS (affecting 10 to 30% of NFAIs) ranged from 12% to 44%. The highest T2DM prevalence in NFAI was 45.2% in one study. MACS versus (non-MACS) NFAIs (n = 16) showed an increased risk of T2DM and even of prediabetes or higher fasting plasma glucose or HbA1c (no unanimous results). T2DM prevalence was analysed in NFAI (N = 1243, female-to-male ratio of 1.11, mean age of 60.42) versus (non-tumour) controls (N = 1548, female-to-male ratio of 0.91, average age of 60.22) amid four studies, and two of them were confirmatory with respect to a higher rate in NFAIs. Four studies included a sub-group of CS compared to NFAI/MACS, and two of them did not confirm an increased rate of glucose profile anomalies in CS versus NFAIs/ACS. The longest period of follow-up with concern to the glycaemic profile was 10.5 years, and one cohort showed a significant increase in the T2DM rate at 17.9% compared to the baseline value of 0.03%. Additionally, inconsistent data from six studies enrolling 1039 individuals that underwent adrenalectomy (N = 674) and conservative management (N = 365) pinpointed the impact of the surgery in NFAIs. The regulation of the glucose metabolism after adrenalectomy versus baseline versus conservative management (n = 3) was improved. To our knowledge, this comprehensive review included one of the largest recent analyses in the field of glucose profile amid the confirmation of MACS/NFAI. In light of the rising incidence of NFAI/AIs due to easier access to imagery scans and endocrine evaluation across the spectrum of modern medicine, it is critical to assess if these patients have an increased frequency of cardio-metabolic disorders that worsen their overall comorbidity and mortality profile, including via the confirmation of T2DM.
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Affiliation(s)
- Alexandra-Ioana Trandafir
- PhD Doctoral School of “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Clinical Endocrinology V, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.G.); (E.P.); (M.C.)
| | - Adina Ghemigian
- Department of Clinical Endocrinology V, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.G.); (E.P.); (M.C.)
- Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihai-Lucian Ciobica
- Department of Internal Medicine and Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Internal Medicine I and Rheumatology, “Dr. Carol Davila” Central Military University Emergency Hospital, 010825 Bucharest, Romania
| | - Claudiu Nistor
- Department 4-Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Thoracic Surgery Department, “Dr. Carol Davila” Central Military University Emergency Hospital, 010242 Bucharest, Romania
| | - Maria-Magdalena Gurzun
- Cardiology Discipline, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Laboratory of Non-Invasive Cardiovascular Exploration, “Dr. Carol Davila” Central Military University Emergency Hospital, 010242 Bucharest, Romania
| | - Tiberiu Vasile Ioan Nistor
- Medical Biochemistry Discipline, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Eugenia Petrova
- Department of Clinical Endocrinology V, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.G.); (E.P.); (M.C.)
- Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mara Carsote
- Department of Clinical Endocrinology V, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.G.); (E.P.); (M.C.)
- Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Tsutsumi T, Nakagomi D, Kobayashi K, Hanai S, Kobayashi Y, Ito R, Ishii T, Okuma H, Uchinuma H, Ichijo M, Tsuchiya K. Moon-like Facies by Glucocorticoid Is Associated With the Development of Diabetes and Body Image Disturbance. J Endocr Soc 2024; 8:bvae036. [PMID: 38481602 PMCID: PMC10928504 DOI: 10.1210/jendso/bvae036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Indexed: 04/07/2024] Open
Abstract
Context Moon-like facies (MLF) are a typical side effect of glucocorticoid (GC) therapy; however, its predisposing factors, relationship with GC-induced complications, and effects on body image are not well understood. Objective This study aimed to determine the predisposing factors for MLF during GC therapy; its association with GC-induced diabetes, hypertension, and dyslipidemia; and its effects on body image. Methods This prospective observational study spanned 24 weeks and targeted patients who received GC therapy at the University of Yamanashi Hospital from June 2020 to August 2022. The MLF was defined based on the following 3 factors: (1) an increase in facial measurement lengths, (2) subjective facial changes by patients' self-assessment using a visual analog scale; (3) objective and qualitative facial changes assessed by physicians. We examined the predisposing factors for MLF and the association of MLF with GC-induced diabetes, hypertension, dyslipidemia, and body image. Results The cumulative incidence rate of MLF at 24 weeks was 37.6%. Predisposing factors for MLF were an initial oral prednisolone dosage of ≥ 30 mg/day [odds ratio (OR) 63.91, 95% confidence interval (CI) 5.82-701.81] and female (OR 6.66, 95% CI 1.35-32.79). MLF showed a significant association with the onset of GC-induced diabetes (OR 6.58, 95% CI 1.25-34.74). MLF was also an independent factor contributing to body image disturbance (β = -18.94, P = .01). Conclusion MLF contributes to body image disturbance and is associated with the development of GC-induced diabetes; therefore, it is clinically important as a physical manifestation of GC therapy.
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Affiliation(s)
- Takahiro Tsutsumi
- Department of Diabetes and Endocrinology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Daiki Nakagomi
- Department of Rheumatology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Kei Kobayashi
- Department of Rheumatology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Shunichiro Hanai
- Department of Rheumatology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Yoshiaki Kobayashi
- Department of Rheumatology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Ryosuke Ito
- Department of Rheumatology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Toshihisa Ishii
- Department of Nephrology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Hideyuki Okuma
- Department of Diabetes and Endocrinology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Hiroyuki Uchinuma
- Department of Diabetes and Endocrinology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Masashi Ichijo
- Department of Diabetes and Endocrinology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Kyoichiro Tsuchiya
- Department of Diabetes and Endocrinology, Graduate School of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
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Terayama R, Ishikawa T, Ishiwata K, Sato A, Minamizuka T, Ohno T, Kono S, Yamamoto M, Yokoh H, Nagano H, Koshizaka M, Suzuki S, Koide H, Maezawa Y, Yokote K. Correction of Hypercortisolemia with an Improved Cognitive Function and Muscle Mass after Transsphenoidal Surgery in an Older Patient with Cushing's Disease. Intern Med 2022; 61:3391-3399. [PMID: 35491128 PMCID: PMC9751722 DOI: 10.2169/internalmedicine.8326-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Cushing's disease causes numerous metabolic disorders, cognitive decline, and sarcopenia, leading to deterioration of the general health in older individuals. Cushing's disease can be treated with transsphenoidal surgery, but thus far, surgery has often been avoided in older patients. We herein report an older woman with Cushing's disease whose cognitive impairment and sarcopenia improved after transsphenoidal surgery. Although cognitive impairment and sarcopenia in most older patients show resistance to treatment, our case indicates that normalization of the cortisol level by transsphenoidal surgery can be effective in improving the cognitive impairment and muscle mass loss caused by Cushing's disease.
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Affiliation(s)
- Ryo Terayama
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Takahiro Ishikawa
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
- Department of General Medical Science, Chiba University Graduate School of Medicine, Japan
- Geriatric Medical Center, Chiba University Hospital, Japan
| | - Kazuki Ishiwata
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Ai Sato
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Takuya Minamizuka
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Tomohiro Ohno
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Satomi Kono
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Masashi Yamamoto
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Hidetaka Yokoh
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Hidekazu Nagano
- Department of Molecular Diagnosis, Graduate School of Medicine, Chiba University, Japan
| | - Masaya Koshizaka
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Sawako Suzuki
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Hisashi Koide
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
| | - Koutaro Yokote
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Japan
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Czapla-Iskrzycka A, Świątkowska-Stodulska R, Sworczak K. Comorbidities in Mild Autonomous Cortisol Secretion - A Clinical Review of Literature. Exp Clin Endocrinol Diabetes 2022; 130:567-576. [PMID: 35817047 DOI: 10.1055/a-1827-4113] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Mild autonomous cortisol secretion (mACS) is a state of cortisol excess usually associated with existence of adrenal incidentaloma. Because of the lack of symptoms of the disease, the biochemical evaluation is the most important to determine a diagnosis. However, scientific societies have different diagnostic criteria for mACS, which makes the treatment of this disease and using results of original papers in daily practice more difficult. Chronic hypercortisolemic state, even if mild, may lead to diseases that are mostly connected with overt Cushing's syndrome. Some of them can cause a higher mortality of patients with mACS and those problems need to be addressed. In this review we describe the comorbidities associated with mACS: cardiovascular disorders, arterial hypertension, diabetes mellitus, insulin resistance, dyslipidemia, obesity, metabolic syndrome, non-alcoholic fatty liver disease, vertebral fractures and osteoporosis. The point of this paper is to characterise them and determine if and how these conditions should be managed. Two databases - PubMed and Web of Science were searched. Even though the evidence are scarce, this is an attempt to lead clinicians through the problems associated with this enigmatic condition.
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Affiliation(s)
- Aleksandra Czapla-Iskrzycka
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Renata Świątkowska-Stodulska
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Sworczak
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Katsuhara S, Yokomoto-Umakoshi M, Umakoshi H, Matsuda Y, Iwahashi N, Kaneko H, Ogata M, Fukumoto T, Terada E, Sakamoto R, Ogawa Y. Impact of Cortisol on Reduction in Muscle Strength and Mass: A Mendelian Randomization Study. J Clin Endocrinol Metab 2022; 107:e1477-e1487. [PMID: 34850018 DOI: 10.1210/clinem/dgab862] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Indexed: 01/11/2023]
Abstract
CONTEXT Prolonged exposure to pathological cortisol, as in Cushing's syndrome causes various age-related disorders, including sarcopenia. However, it is unclear whether mild cortisol excess, for example, accelerates sarcopenia due to aging or chronic stress. OBJECTIVE We used Mendelian randomization (MR) analysis to assess whether cortisol was causally associated with muscle strength and mass. METHODS Three single-nucleotide polymorphisms associated with plasma cortisol concentrations in the CORtisol NETwork consortium (n = 12 597) were used as instrumental variables. Summary statistics with traits of interest were obtained from relevant genome-wide association studies. For the primary analysis, we used the fixed-effects inverse-variance weighted analysis accounting for genetic correlations between variants. RESULTS One SD increase in cortisol was associated with SD reduction in grip strength (estimate, -0.032; 95% CI -0.044 to -0.020; P = 3e-04), whole-body lean mass (estimate, -0.032; 95% CI, -0.046 to -0.017; P = 0.004), and appendicular lean mass (estimate, -0.031; 95% CI, -0.049 to -0.012; P = 0.001). The results were supported by the weighted-median analysis, with no evidence of pleiotropy in the MR-Egger analysis. The association of cortisol with grip strength and lean mass was observed in women but not in men. The association was attenuated after adjusting for fasting glucose in the multivariable MR analysis, which was the top mediator for the association in the MR Bayesian model averaging analysis. CONCLUSION This MR study provides evidence for the association of cortisol with reduced muscle strength and mass, suggesting the impact of cortisol on the development of sarcopenia.
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Affiliation(s)
- Shunsuke Katsuhara
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Maki Yokomoto-Umakoshi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hironobu Umakoshi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yayoi Matsuda
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Norifusa Iwahashi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroki Kaneko
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masatoshi Ogata
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tazuru Fukumoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eriko Terada
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryuichi Sakamoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Ogawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Li S, Schönke M, Buurstede JC, Moll TJ, Gentenaar M, Schilperoort M, Visser JA, Kaikaew K, van de Vijver D, Abbassi-Daloii T, Raz V, Aartsma-Rus A, van Putten M, Meijer OC, Kroon J. Sexual Dimorphism in Transcriptional and Functional Glucocorticoid Effects on Mouse Skeletal Muscle. Front Endocrinol (Lausanne) 2022; 13:907908. [PMID: 35898460 PMCID: PMC9309696 DOI: 10.3389/fendo.2022.907908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/17/2022] [Indexed: 11/23/2022] Open
Abstract
Muscle atrophy is common in patients with increased glucocorticoid exposure. Glucocorticoid effects are often sex-specific, and while different glucocorticoid responses between male and female subjects are reported, it is unclear why this is. In this study, we evaluated the effects of corticosterone and synthetic glucocorticoid treatment on muscle atrophy in male and female mice. We found that corticosterone treatment reduced grip strength in female mice only, whereas muscle mass was reduced in both sexes. Skeletal muscle transcriptional responses to corticosterone treatment were more pronounced and widespread in male mice. Synthetic glucocorticoid treatment reduced grip strength in both sexes, while female mice were more sensitive to muscle atrophy than male mice. To evaluate the role of androgens, chemically-castrated male mice were treated with synthetic glucocorticoids. We observed additively reduced muscle mass, but did not observe any interaction effects. Although sex differences in glucocorticoid responses in skeletal muscle are partly influenced by androgen signaling, further studies are warranted to fully delineate the underlying mechanisms.
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Affiliation(s)
- Sheng Li
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Milena Schönke
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Jacobus C. Buurstede
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Tijmen J.A. Moll
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Max Gentenaar
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Maaike Schilperoort
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Jenny A. Visser
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Kasiphak Kaikaew
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Davy van de Vijver
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Tooba Abbassi-Daloii
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Vered Raz
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | | | - Maaike van Putten
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Onno C. Meijer
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Jan Kroon
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, Netherlands
- *Correspondence: Jan Kroon,
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Gonzalez Rodriguez E, Marques-Vidal P, Aubry-Rozier B, Papadakis G, Preisig M, Kuehner C, Vollenweider P, Waeber G, Hans D, Lamy O. Diurnal Salivary Cortisol in Sarcopenic Postmenopausal Women: The OsteoLaus Cohort. Calcif Tissue Int 2021; 109:499-509. [PMID: 34003339 PMCID: PMC8484096 DOI: 10.1007/s00223-021-00863-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/30/2021] [Indexed: 01/06/2023]
Abstract
Sarcopenia, similar to hypercortisolism, is characterized by loss of muscle mass and strength. Cortisol circadian rhythm changes with aging (blunted late-day nadir values) were suggested to contribute to this decline. We aimed to explore the relationship between diurnal salivary cortisol values and sarcopenia diagnosis and its components in postmenopausal women. This is a cross-sectional study within the OsteoLaus population-based cohort in Lausanne (Switzerland). Participants had a body composition assessment by dual X-ray absorptiometry (DXA), a grip strength (GS) measure, and salivary cortisol measures (at awakening, 30 min thereafter, 11 AM (sc-11AM) and 8 PM (sc-8PM)). Associations between salivary cortisol and sarcopenia diagnosed by six different criteria (based on appendicular lean mass (ALM) assessed by DXA, and muscle strength by GS), and its components, were analyzed. 471 women aged > 50 years (63.0 ± 7.5) were included. Various definitions identified different participants as sarcopenic, who consistently presented higher salivary cortisol at 11 AM and/or 8 PM. There were no associations between salivary cortisol levels and ALM measures, either absolute or after correction to height squared (ALM index) or body mass index. GS was inversely correlated to sc-11AM (r = - 0.153, p < 0.001) and sc-8PM (r = - 0.118, p = 0.002). Each 10 nmol/l increase of sc-11AM, respectively sc-8PM, was associated with a GS decrease of 1.758 (SE 0.472) kg, respectively 2.929 (SE 1.115) kg. In postmenopausal women, sarcopenia is associated with higher salivary cortisol levels at 11 AM and 8 PM. An increase of daily free cortisol levels in the physiological range could participate to sarcopenia development by decreasing muscle function in postmenopausal women.
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Affiliation(s)
- Elena Gonzalez Rodriguez
- Interdisciplinary Center for Bone Diseases, Service of Rhumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Interdisciplinary Center of Bone Diseases, Service of Rheumatology, CHUV, Lausanne University Hospital, Rue Pierre-Decker 4, 1011, Lausanne, Switzerland.
| | - Pedro Marques-Vidal
- Service of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Bérengère Aubry-Rozier
- Service of Genetic Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Georgios Papadakis
- Service of Endocrinology, Diabetology and Metabolism, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Epidemiology and Psychopathology Research Unit, Department of Psychiatrics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Peter Vollenweider
- Service of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gerard Waeber
- Service of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Didier Hans
- Interdisciplinary Center for Bone Diseases, Service of Rhumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Lamy
- Interdisciplinary Center for Bone Diseases, Service of Rhumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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8
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Triki L, Ben Saad H. The impacts of parity on spirometric parameters: a systematic review. Expert Rev Respir Med 2021; 15:1169-1185. [PMID: 34033730 DOI: 10.1080/17476348.2021.1935246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Introduction: The relationship between parity and health outcomes has been debated in the scientific literature in terms of 'selection-pressure'. However, no previous review has raised the impacts of parity on spirometric parameters. This Systematic Review aimed to review the impacts of parity on spirometric parameters.Areas covered: PubMed and Scopus were searched on October 1st, 2020, using the combination of the following two medical subject headings: 'Parity' and 'Respiratory Function Tests'. Only original articles published in English/French were retained. Ten studies investigated the impacts of parity on spirometric parameters: six included healthy females, three involved unhealthy females [chronic obstructive pulmonary disease, defect in protease inhibitor, and some other conditions] and one included a mixed population of healthy/unhealthy females. The studies reported conflicting results: no impact, positive impact (multiparity is associated with larger forced-expiratory-volume in one second, forced- and slow- vital-capacity, and inspiratory-capacity), or negative impact (multiparous females has lower bronchial flows, higher static volumes, an accelerated lung-aging, a tendency to an obstructive-ventilatory-defect and/or to lung-hyperinflation, and increased protease inhibitor levels).Expert opinion: The ten studies presented some limitations that made data interpretation relatively difficult. Future research to identify the 'real' impact of parity on spirometric parameters are therefore encouraged.
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Affiliation(s)
- Leila Triki
- Department of Physiology and Functional Exploration, Habib BOURGUIBA Hospital, Sfax, Tunisia
| | - Helmi Ben Saad
- Department of Physiology and Functional Exploration, Farhat HACHED University Hospital of Sousse, Sousse, Tunisia.,Heart Failure Research Laboratory (LR12SP09), Farhat HACHED Hospital, Sousse, Tunisia.,Faculté De Médecine De Sousse, Laboratoire De Physiologie, Université De Sousse. Sousse, Tunisie
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9
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Vogel F, Braun LT, Rubinstein G, Zopp S, Künzel H, Strasding F, Albani A, Riester A, Schmidmaier R, Bidlingmaier M, Quinkler M, Deutschbein T, Beuschlein F, Reincke M. Persisting Muscle Dysfunction in Cushing's Syndrome Despite Biochemical Remission. J Clin Endocrinol Metab 2020; 105:dgaa625. [PMID: 32882010 PMCID: PMC7538105 DOI: 10.1210/clinem/dgaa625] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/31/2020] [Indexed: 01/09/2023]
Abstract
CONTEXT Glucocorticoid-induced myopathy is a characteristic symptom of endogenous Cushing's syndrome (CS). Its long-term outcome is largely unknown. OBJECTIVE To evaluate long-term muscle function following the remission of endogenous CS. STUDY DESIGN Observational longitudinal cohort study. SETTING Tertiary care hospitals and a specialized outpatient clinic. PATIENTS As part of the prospective multicenter German Cushing's Registry, we assessed muscle strength in patients with overt endogenous CS. We studied the patients at the time of diagnosis (n = 88), after 6 months (n = 69), and thereafter annually, following surgical remission over a period of up to 4 years (1 year: n = 55; 2 years: n = 34; 3 years: n = 29; 4 years: n = 22). Muscle function was evaluated by hand grip strength and by chair rising test. RESULTS Grip strength was decreased to 83% of normal controls (100%) at the time of diagnosis. It further decreased to 71% after 6 months in remission (P ≤ 0.001) and showed no improvement during further follow-up compared with baseline. Chair rising test performance improved initially (8 seconds at baseline vs 7 seconds after 6 months, P = 0.004) but remained at this reduced level thereafter (7 seconds after 3 years vs 5 seconds in controls, P = 0.038). In multivariate analysis, we identified, as predictors for long-term muscle dysfunction, age, waist-to-hip ratio, and hemoglobin A1c at baseline. Furthermore, muscle strength during follow-up was strongly correlated with quality of life. CONCLUSION This study shows that CS-associated myopathy does not spontaneously resolve during remission. This calls for action to identify effective interventions to improve muscle dysfunction in this setting.
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Affiliation(s)
- Frederick Vogel
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | - Leah T Braun
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | - German Rubinstein
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | - Stephanie Zopp
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | - Heike Künzel
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | - Finn Strasding
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | - Adriana Albani
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | - Anna Riester
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | - Ralf Schmidmaier
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | - Martin Bidlingmaier
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
| | | | - Timo Deutschbein
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - Felix Beuschlein
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, UniversitätsSpital Zürich, Zürich, Switzerland
| | - Martin Reincke
- Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, München, Germany
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10
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Kroon J, Pereira AM, Meijer OC. Glucocorticoid Sexual Dimorphism in Metabolism: Dissecting the Role of Sex Hormones. Trends Endocrinol Metab 2020; 31:357-367. [PMID: 32037025 DOI: 10.1016/j.tem.2020.01.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/20/2019] [Accepted: 01/13/2020] [Indexed: 12/15/2022]
Abstract
Glucocorticoids are steroid hormones that are of pivotal importance in human physiology. Glucocorticoid signaling is complex in nature and dependent on many interacting factors. As glucocorticoids exhibit sexually dimorphic effects on several key processes including in metabolism, crosstalk with the sex steroid hormones (androgens and estrogens) is relevant. In this review, we highlight the state-of-the-art knowledge on glucocorticoid sexual dimorphism and sex hormone crosstalk. We include current insight in the molecular mechanisms that underlie nuclear steroid receptor crosstalk, and sex hormone effects on glucocorticoid metabolism. Finally, we show how these findings translate to humans exposed to excess glucocorticoid signaling, and we propose future avenues in the emerging field of steroid hormone crosstalk.
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Affiliation(s)
- Jan Kroon
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands.
| | - Alberto M Pereira
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Onno C Meijer
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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11
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Abstract
The European society of endocrinology, in association with the European network for the study of adrenal tumors, published recommendations for the diagnosis and treatment of adrenal incidentalomas in 2016. A thorough and critical analysis of the literature was performed to establish evidence-based recommendations and expert suggestions with the aim of avoiding 'over-diagnosis' and 'over-treatment' and to reduce unnecessary investigations, surgery and follow-up. The purpose of this review is to reconsider several recommendations that are open to debate, such as imaging of adrenal incidentalomas, diagnosis of pheochromocytoma, diagnosis and treatment of autonomous cortisol-secreting tumors, investigations of bilateral AI and follow-up of non-operated AIs, based on studies published after the release of the recommendations.
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Affiliation(s)
- Sophie Cambos
- Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France
| | - Antoine Tabarin
- Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France; Inserm U1215, Neurocentre Magendie, University of Bordeaux, 146 Rue Leo Saignat, 33076 Bordeaux Cedex, France.
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12
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Batista SL, de Araújo IM, Carvalho AL, Alencar MAVSD, Nahas AK, Elias J, Nogueira-Barbosa MH, Salmon CEG, Elias PCL, Moreira AC, Castro M, de Paula FJA. Beyond the metabolic syndrome: Visceral and marrow adipose tissues impair bone quantity and quality in Cushing's disease. PLoS One 2019; 14:e0223432. [PMID: 31613908 PMCID: PMC6793883 DOI: 10.1371/journal.pone.0223432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/20/2019] [Indexed: 12/17/2022] Open
Abstract
The present study was designed to evaluate the relationship between bone traits [bone mineral density (BMD) and trabecular bone score (TBS)] and the accumulation of fat in adipose tissues [abdominal subcutaneous (SAT), visceral (VAT), marrow (MAT) and intrahepatic lipids (IHL)], as well as insulin resistance, in subjects with Cushing’s disease (CD). The study included control (C = 27), paired (P = 16) and Cushing’s disease (CD = 10) groups, which underwent biochemical assessment, dual X-ray absorptiometry, TBS, and magnetic resonance imaging to determine fat deposits. The CD group showed higher serum levels of glucose and insulin, as well as HOMA-IR values, but lower circulatory levels of osteocalcin, in comparison to C and P. The CD group exhibited lower L1-L4 BMD than P (P = 1.059 ± 0.141 vs CD = 0.935 ± 0.093 g/cm2, p < 0.05) (Fig 1A). The lumbar spine BMD from the C group was similar to the other groups. TBS was lower in CD than in P and C (C = 1.512±0.077 vs P = 1.405±0.150 vs CD = 1.135±0.136; p<0.05); there was also significant difference between C and P (p<0.05). MAT, VAT, and IHL were higher in CD than in C and P (p<0.05). Considering all subjects, there was a positive association between TBS with both lumbar spine BMD (R2 = 0.45; p<0.0001) and osteocalcin (R2 = 0.44; p = 0.05). TBS was negatively associated with MAT (R2 = 0.49; p = 0.01), VAT (R2 = 0.55; p<0.05), and HOMA-IR (R2 = 0.44; p<0.01). MAT was positively related with VAT (R2 = 0.44; p<0.01) and IHL (R2 = 0.41; p<0.05). In CD, insulin resistance and adipose tissue dysfunction, including high MAT, are active players in bone deterioration, as confirmed by lower lumbar spine BMD and lower TBS. Thus, our findings point to an additional component of the already well-known complex mechanisms of osteoporosis associated with hypercortisolism.
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Affiliation(s)
- Sérgio Luchini Batista
- Department of Clinical Medicine, Ribeirão Preto Medical School, USP, Ribeirão Preto, SP, Brazil
| | | | - Adriana Lelis Carvalho
- Department of Clinical Medicine, Ribeirão Preto Medical School, USP, Ribeirão Preto, SP, Brazil
| | | | | | - Jorge Elias
- Department of Clinical Medicine, Ribeirão Preto Medical School, USP, Ribeirão Preto, SP, Brazil
| | | | - Carlos E. G. Salmon
- Department of Physics, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Paula C. L. Elias
- Department of Clinical Medicine, Ribeirão Preto Medical School, USP, Ribeirão Preto, SP, Brazil
| | - Ayrton C. Moreira
- Department of Clinical Medicine, Ribeirão Preto Medical School, USP, Ribeirão Preto, SP, Brazil
| | - Margaret Castro
- Department of Clinical Medicine, Ribeirão Preto Medical School, USP, Ribeirão Preto, SP, Brazil
| | - Francisco J. A. de Paula
- Department of Clinical Medicine, Ribeirão Preto Medical School, USP, Ribeirão Preto, SP, Brazil
- * E-mail:
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13
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Delivanis DA, Athimulam S, Bancos I. Modern Management of Mild Autonomous Cortisol Secretion. Clin Pharmacol Ther 2019; 106:1209-1221. [PMID: 31206616 DOI: 10.1002/cpt.1551] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/04/2019] [Indexed: 12/13/2022]
Abstract
Incidentally discovered adrenal tumors are reported in ~ 5% of adults undergoing cross-sectional imaging. Mild autonomous cortisol secretion (MACS) from the adrenal mass is demonstrated in 5-48% of patients with adrenal tumors. The diagnosis of MACS represents a challenge due to limitations of the currently used diagnostic tests, differences in the definitions of the clinically relevant MACS, and heterogeneity in an individual's susceptibility to abnormal cortisol secretion from the adrenal mass. Patients with MACS present with increased risk of cardiovascular risk factors, cardiovascular events, metabolic bone disease, and mortality. Adrenalectomy improves or reverses MACS-associated comorbidities in selected patients. The current review will address diagnostic and management challenges in the care of patients with MACS, discuss data on emerging biomarkers, and suggest future directions in the field of MACS.
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Affiliation(s)
- Danae A Delivanis
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Shobana Athimulam
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Irina Bancos
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
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14
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Moraes AB, Cavalari EMR, de Paula MP, Arruda M, Curi DSC, Leitão RA, de Mendonça LMC, Farias MLF, Madeira M, Vieira Neto L. Evaluation of body composition using dual-energy X-ray absorptiometry in patients with non-functioning adrenal incidentalomas and an intermediate phenotype: Is there an association with metabolic syndrome? J Endocrinol Invest 2019; 42:797-807. [PMID: 30465247 DOI: 10.1007/s40618-018-0985-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/15/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Metabolic syndrome (MS) and sarcopenia are associated with increased cardiovascular risk. No studies using dual-energy x-ray absorptiometry (DXA) have evaluated association between body composition (BC) changes and MS in adrenal incidentaloma (AI). Our aim was to analyse BC in non-functioning AI (NFAI) and intermediate phenotype (IP) relative to controls and to correlate with cortisol levels. METHODS Cross-sectional study with 44 NFAI (serum cortisol ≤ 50 nmol/L after the overnight 1 mg dexamethasone suppression test), 27 IP (cortisol 51-138 nmol/L), and 41 controls (normal adrenal on imaging examination) using DXA. Autonomic cortisol secretion (cortisol > 138 nmol/L) was excluded from the study. BC data were compared using criteria for MS (World Health Organization, National Cholesterol Education Program-Adult Treatment Panel-III, American Association of Clinical Endocrinologists (AACE), and International Diabetes Federation). RESULTS There was no significant difference in clinical data and body mass index (BMI) among the three groups. Waist circumference (WC) was larger in AI vs. controls (p < 0.01). Waist-to-hip ratio was higher in NFAI vs. controls and waist-to-height ratio was higher in IP vs. controls (p = 0.03 and p = 0.02, respectively). The frequency of MS was higher in AI vs. controls. BC was not different among the groups. Patients with AI there was a significant association of MS with both an increase in total fat and body fat index (all criteria), and a significant difference between MS and smaller BMI-adjusted lean mass (AACE, p = 0.036). No correlation of cortisol after 1 mg dexamethasone test with BC or MS. AI and WC were independently associated with MS. CONCLUSIONS AI presented high frequency of MS and was independently associated with MS. Possible deleterious effects of cortisol secretion seem to initially affect the muscular system.
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Affiliation(s)
- A B Moraes
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - E M R Cavalari
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - M P de Paula
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - M Arruda
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - D S C Curi
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - R A Leitão
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - L M C de Mendonça
- Department of Internal Medicine and Rheumatology Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rio De Janeiro, RJ, Brazil
| | - M L F Farias
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - M Madeira
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
- Endocrinology Unit, Bonsucesso Federal Hospital, Rio de Janeiro, RJ, Brazil
| | - L Vieira Neto
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil.
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15
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Borba VZC, Costa TL, Moreira CA, Boguszewski CL. MECHANISMS OF ENDOCRINE DISEASE: Sarcopenia in endocrine and non-endocrine disorders. Eur J Endocrinol 2019; 180:R185-R199. [PMID: 30913536 DOI: 10.1530/eje-18-0937] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/26/2019] [Indexed: 12/11/2022]
Abstract
Objective This paper reviews the main mechanisms, diagnostic criteria, treatment options and available data on sarcopenia in endocrine and non-endocrine disorders. The literature notes the presence of sarcopenia as a comorbid condition or a complication of another clinical situation and not a disease that only affects elderly patients. Method We performed a literature review, focusing on the following: mechanisms related to sarcopenia in elderly patients, and sarcopenia as it presents in the context of chronic and endocrine diseases; diagnostic tools and methods; aspects of sarcopenia and treatment options specific to chronic diseases and endocrine disorders respectively. Results Sarcopenia in chronic and endocrine disorders shares many mechanisms with sarcopenia affecting elderly patients, but certain diseases can have a predominant aspect that leads to sarcopenia. The prevalence of sarcopenia varies, depending on different diagnostic criteria, from around 12 to 60% in chronic illnesses and 15 to 90% in endocrine disorders. The interplay between sarcopenia, chronic diseases and elderly patients requires further study, to clarify the impact of each, in terms of prognosis and mortality. Conclusion Awareness of the presentation of sarcopenia in the context of other diseases and ages (and not just the elderly) is fundamental to ensure that preventive measures can be deployed.
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Affiliation(s)
| | - Tatiana Lemos Costa
- Endocrine Division (SEMPR), Hospital de Clinicas, Federal University of Paraná, Curitiba, Brazil
| | - Carolina Aguiar Moreira
- Endocrine Division (SEMPR), Hospital de Clinicas, Federal University of Paraná, Curitiba, Brazil
- Pro-Renal Brasil, Lab PRO, Bone Histomorphometry Section, Curitiba, Brazil
| | - Cesar Luiz Boguszewski
- Endocrine Division (SEMPR), Hospital de Clinicas, Federal University of Paraná, Curitiba, Brazil
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