MRI assessment of lean and adipose tissue distribution in female patients with Cushing's disease.
OBJECTIVE
Chronic hypercortisolemia due to Cushing's disease (CD) results in abnormal adipose tissue (AT) distribution. Whole-body magnetic resonance imaging (MRI) was used to examine lean and AT distribution in female patients with CD to further understand the role of glucocorticoid excess in the development of abnormal AT distribution and obesity.


METHODS
Cross-sectional and case-control study.


METHODS
Fifteen women with CD and 12 healthy controls.


METHODS
Mass of skeletal muscle (SM) and AT in the visceral (VAT), subcutaneous (SAT), and intermuscular (IMAT) compartments from whole-body MRI and serum levels of insulin, glucose, and leptin were measured.


RESULTS
CD patients had leptin values that correlated to total AT (TAT) and SAT (P < 0.05) but not to VAT. CD patients had higher VAT/TAT ratios (P < 0.01) and lower SAT/TAT ratios (P < 0.05) compared to controls. TAT, VAT, and trunk SAT (TrSAT) were greater in CD patients (P < 0.01). SM was less in CD (P < 0.001) but IMAT was not different.


CONCLUSIONS
TAT, VAT, trSAT, and the proportion of AT in the visceral depot were greater in CD although the proportion in the subcutaneous depot was less. SM was less but IMAT was not different. These findings have implications for understanding the role of cortisol in the abnormal AT distribution and metabolic risk seen in patients exposed to chronic excess glucocorticoids.
Geer
Eliza B
EB
Department of Medicine, Mount Sinai Medical Center, St Luke’s-Roosevelt Hospital, Columbia University, New York, NY 10029, USA.
Shen
Wei
W
Gallagher
Dympna
D
Punyanitya
Mark
M
Looker
Helen C
HC
Post
Kalmon D
KD
Freda
Pamela U
PU
D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D000368:Aged; D001823:Body Composition; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D047748:Pituitary ACTH Hypersecretion / Q000378:metabolism*; D011446:Prospective Studies
D020738:Leptin; D006854:Hydrocortisone