Effect of mild cortisol cosecretion on body composition and metabolic parameters in patients with primary hyperaldosteronism

CLINICAL ENDOCRINOLOGY(2024)

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摘要
ObjectiveTo 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.DesignRetrospective cohort study.PatientsForty-seven patients with PA and CCS confirmed by 1-mg dexamethasone suppression test (DST) with a cutoff of >= 1.8 mu g/dL were compared with PA patients with excluded CCS (non-CCS, n = 47) matched by age and sex.MethodsSegmentation 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.ResultsMean cortisol after DST was 1.2 mu g/dL (33.1 nmol/L) in the non-CCS group and 3.2 mu g/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.ConclusionMACE 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.
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关键词
body composition,cortisol cosecretion,primary hyperaldosteronism
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