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Alteration in skeletal muscle mass in women with subclinical hypercortisolism

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Abstract

Purpose

Despite the well-known deleterious effects of cortisol on skeletal muscle, whether subtle cortisol excess in subclinical hypercortisolism (SH) affects skeletal muscle mass is unknown. Our objective was to understand the effects of the cortisol level on skeletal muscle mass in patients with SH.

Methods

We compared skeletal muscle mass and fat mass (FM) between 21 patients with SH (12 women and 9 men) and 224 controls (67 women and 157 men) with nonfunctioning adrenal incidentaloma (NFAI). Medical records were reviewed, and we measured body composition parameters using bioelectrical impedance analysis and serum cortisol levels after the overnight 1-mg dexamethasone suppression test (DST).

Results

After adjusting for confounding factors, 1-mg DST levels were inversely correlated with appendicular skeletal muscle mass (ASM) (γ = −0.245, P = 0.040), lower limb ASM (γ = −0.244, P = 0.040), and appendicular skeletal muscle index (ASMI; height-adjusted ASM) (γ = −0.229, P = 0.048) in all women, but not men. ASM and ASMI were significantly lower by 6.2% (P = 0.033) and 5.9% (P = 0.046), respectively, in women with SH compared with those with NFAI, but not men. Conversely, FM and percent fat mass were similar between the two groups. Compared with women with NFAI, among those with SH, lower limb, but not upper limb, ASM was lower by 6.8% (P = 0.020).

Conclusions

This study showed that women with SH had lower skeletal muscle mass, especially of the lower limb, and suggested that subtle cortisol excess also has adverse effects on skeletal muscle metabolism.

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Acknowledgements

This study was supported by grants from the Asan Institute for Life Sciences, Seoul, Republic of Korea (Project No.2014-1215).

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea

    Jae Hyeon Kim

  2. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea

    Mi Kyung Kwak, Beom-Jun Kim, Seung Hun Lee & Jung-Min Koh

  3. Department of Endocrinology, Inha University School of Medicine, Incheon, 22332, Korea

    Seong Hee Ahn

  4. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Medical Center, Seoul, Korea

    Hyeonmok Kim

  5. Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University School of Medicine, Jinju, Korea

    Yoon Young Cho

  6. Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea

    Sunghwan Suh

  7. Division of Endocrinology and Metabolism, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

    Kee-Ho Song

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Correspondence to Seung Hun Lee.

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These authors are co-first authors: Jae Hyeon Kim and Mi Kyung Kwak.

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Kim, J.H., Kwak, M.K., Ahn, S.H. et al. Alteration in skeletal muscle mass in women with subclinical hypercortisolism. Endocrine 61, 134–143 (2018). https://doi.org/10.1007/s12020-018-1598-0

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  • DOI: https://doi.org/10.1007/s12020-018-1598-0

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