Lee Bo-Ching, Chang Yu-Ling, Chen Po-Ting, Liu Li-Wen, Liu Kao-Lang, Chang Chin-Chen, Wu Vin-Cent, Lin Yen-Hung
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Department and Graduate Institute of Forensic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Hypertens Res. 2025 Feb;48(2):519-528. doi: 10.1038/s41440-024-01933-y. Epub 2024 Oct 14.
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.
患有肾上腺醛固酮分泌腺瘤（APA）的患者面临着更高的心血管疾病风险，尤其是在同时分泌皮质醇的情况下，然而其对肌肉健康的影响仍不清楚。以脂肪浸润肌肉为特征的肌脂肪变性与心脏代谢疾病和生存率降低有关。我们旨在研究APA患者自主皮质醇分泌（ACS）与肌肉量和质量之间的关联。在本研究中，我们分析了2009年至2024年间228例接受腹腔镜肾上腺切除术的APA患者的数据，通过计算机断层扫描评估肌肉组成。测量了肌间脂肪组织（IMAT）、骨骼肌面积和密度、L3水平的内脏和皮下脂肪组织面积。对ACS组和非ACS组进行了比较。我们发现，在228例患者中，76例（33.3%）有ACS。有ACS的患者IMAT面积显著更高（P = 0.042），骨骼肌面积（P = 0.002）和密度（P < 0.001）更低。多变量回归证实ACS与IMAT面积呈正相关，与骨骼肌面积和密度呈负相关。在1年随访时，ACS患者（n = 15）肾上腺切除术后IMAT面积减少（P = 0.001），骨骼肌面积增加（P = 0.031），而无ACS的患者（n = 29）IMAT无变化，但内脏（P < 0.001）和皮下（P = 0.008）脂肪组织面积增加。总之，肌脂肪变性和肌肉减少症与APA患者的ACS有关，肾上腺切除术后这些参数会改善。
