Impact of cortisol on liver fat and metabolic health in adrenal incidentalomas and Cushing's syndrome.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-09-25 DOI:10.1007/s12020-024-04043-4

Peng Yu, Haoyue Yuan, Xiaomu Li, Hong Chen

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引用次数: 0

Abstract

Objective: To evaluate liver fat content in patients with non-functional adrenal incidentalomas (NFAI), mild autonomous cortisol secretion (MACS), and Cushing's syndrome (CS), and assess its relationship with cortisol levels.

Methods: This cross-sectional study used retrospective data from 103 NFAI patients, 100 MACS (serum cortisol after a 1-mg dexamethasone test >50 nmol/L), and 59 with CS. Abdominal CT scans measured hepatic and splenic CT values to calculate the liver-to-spleen (L/S) ratio. Metabolic indicators including fasting plasma glucose (FPG), LDL-c, HDL-c, HbA1c, etc were measured. Mediation analysis was used to explore the indirect effects of metabolic traits on the cortisol-liver fat relationship.

Results: Patients included 103 NFAI, 100 MACS, and 59 CS. MACS patients had higher NAFLD prevalence (57%) than NFAI (26.2%, p < 0.001) but lower than CS (66.1%, p < 0.001). MACS and CS were associated with NAFLD (OR 3.83 and OR 5.73, p < 0.01), adjusted for age, body mass index (BMI), and covariates. Midnight serum cortisol correlated with L/S ratio (p < 0.001). HbA1c and Triglyceride-glucose index (TyG) mediated 24.5% and 49.5% of the cortisol and L/S ratio association, respectively. FPG, HbA1c, HDL-c, and TyG mediated the association between MACS or CS and the L/S ratio. Homeostasis model assessment of insulin resistance (HOMA-IR), fructosamine, and triglycerides mediated for MACS, while alkaline phosphatase did so for CS. Total cholesterol, LDL-c, ALT, AST, γ-GT, insulin, and uric acid did not mediate the association.

Conclusion: MACS and CS are linked to significant metabolic disturbances, including increased liver fat and impaired glucose and lipid metabolism, contributing to fatty liver.

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皮质醇对肾上腺偶发瘤和库欣综合征患者肝脏脂肪和代谢健康的影响。

目的评估非功能性肾上腺偶发瘤（NFAI）、轻度自主皮质醇分泌（MACS）和库欣综合征（CS）患者的肝脏脂肪含量，并评估其与皮质醇水平的关系：这项横断面研究使用了 103 名 NFAI 患者、100 名 MACS（1 毫克地塞米松测试后血清皮质醇>50 毫摩尔/升）患者和 59 名 CS 患者的回顾性数据。腹部 CT 扫描测量了肝脏和脾脏 CT 值，以计算肝脾比值 (L/S)。代谢指标包括空腹血浆葡萄糖（FPG）、低密度脂蛋白胆固醇（LDL-c）、高密度脂蛋白胆固醇（HDL-c）、糖化血红蛋白（HbA1c）等。采用中介分析法探讨代谢特征对皮质醇-肝脏脂肪关系的间接影响：患者包括 103 名 NFAI、100 名 MACS 和 59 名 CS。MACS患者的非酒精性脂肪肝患病率（57%）高于NFAI（26.2%，P 结论：MACS和CS与皮质醇-肝脏脂肪关系密切：MACS和CS与严重的代谢紊乱有关，包括肝脏脂肪增加、葡萄糖和脂质代谢受损，从而导致脂肪肝。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.