MRI assessment of lean and adipose tissue distribution in female patients with Cushing's disease

P>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. Design Cross-sectional and case-control study. Patients Fifteen women with CD and 12 healthy controls. Measurements 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 center dot 05) but not to VAT. CD patients had higher VAT/TAT ratios (P < 0 center dot 01) and lower SAT/TAT ratios (P < 0 center dot 05) compared to controls. TAT, VAT, and trunk SAT (TrSAT) were greater in CD patients (P < 0 center dot 01). SM was less in CD (P < 0 center dot 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.