title: Computed tomography assessment of fat distribution in male and female patients with Cushing's syndrome.
abstract: OBJECTIVE
  Our aims were to describe the abdominal fat distribution in male patients with Cushing's syndrome (CS) on computerised tomography (CT), to compare our findings with non-cushingoid patients, to validate previous reports of increased visceral fat in female patients with CS and to identify any correlations between fat distribution and biochemical findings.
  
  
  METHODS
  Retrospective and observational.
  
  
  METHODS
  Appropriate CT scans were identified in 31 patients (seven male) with active CS.
  
  
  METHODS
  Total, visceral and subcutaneous fat areas were obtained. The percentage of visceral fat and the visceral to subcutaneous fat ratio (V:S ratio) were calculated. Biochemical data were recorded. Control data of fat distribution were obtained from the literature.
  
  
  RESULTS
  There was a significant increase in the V:S ratio in male patients with CS when compared with non-cushingoid controls (1.175+/-0.59 vs 0.77+/-0.39, 95% confidence interval (CI) 0.0817-0.728). There was a significant increase in the V:S ratio in female patients with CS (0.845+/-0.53 vs 0.38+/-0.19, 95% CI 0.269-0.661). There was no difference in the V:S ratio between male and female patients with CS (1.175+/-0.59 vs 0.845+/-0.53, 95% CI -0.144-0.804). No significant correlations between fat distribution and glucose levels, circulating cortisol, ACTH or lipids were found.
  
  
  CONCLUSIONS
  Our data demonstrate an increase in visceral fat distribution in both male and female patients with CS, with the abolition of the normal male to female difference in visceral fat. Increased visceral fat may increase the risk of the metabolic syndrome in this group of patients.
authors.affiliation: Department of Diagnostic Radiology, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK. a.g.rockall@qmul.ac.uk
authors.forename: A G
authors.initials: AG
authors.lastname: Rockall
authors.forename: S A
authors.initials: SA
authors.lastname: Sohaib
authors.forename: D
authors.initials: D
authors.lastname: Evans
authors.forename: G
authors.initials: G
authors.lastname: Kaltsas
authors.forename: A M
authors.initials: AM
authors.lastname: Isidori
authors.forename: J P
authors.initials: JP
authors.lastname: Monson
authors.forename: G M
authors.initials: GM
authors.lastname: Besser
authors.forename: A B
authors.initials: AB
authors.lastname: Grossman
authors.forename: R H
authors.initials: RH
authors.lastname: Reznek
mesh_terms: D000005:Abdomen / Q000503:physiopathology*; D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001823:Body Composition; D003480:Cushing Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012727:Sex Characteristics; D014057:Tomography, X-Ray Computed