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The potential role of increased adrenal volume in the pathophysiology of obesity-related Type 2 diabetes

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Abstract

The hypothalamic-pituitary-adrenal (HPA) axis seems to play an important role in obesity and Type 2 diabetes (DM). The aim of the present study was to determine the adrenal volume in obese patients with DM in comparison to obese non-diabetic patients. Eleven diabetic obese and 19 non-diabetic obese women were sequentially invited to take part in the study. Computed tomography (CT) scan of the abdomen was performed to determine adrenal volume, visceral (VF) and sc fat (SCF). Daily urinary free cortisol (UFC) was used as a measure of integrated cortisol production. In the diabetic patients, hemoglobin A1c was measured as an index of metabolic control. Compared to non-diabetic controls, patients with diabetes had a significantly higher total adrenal volume (4.29±1.50 vs 2.95±1.64; p=0.03). A highly significant correlation was detected between VF and VF/SCF ratio and total adrenal volume in the whole group (r=0.36, p=0.04 and r=0.48, p=0.008, respectively). This study, therefore, suggests an association between abdominal obesity, enlarged adrenals and Type 2 diabetes. These findings support the hypothesis that an increased activity of the HPA axis in obese subjects may be involved in the pathogenesis of Type 2 diabetes.

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References

  1. Bjorntorp P, Rosmond R. Obesity and Cortisol. Nutrition 2000, 16: 924–36.

    Article  CAS  PubMed  Google Scholar 

  2. Grassi G, Seravalle G, Dell’Oro R, et al. Participation of the hypothalamus-hypophysis axis in the sympathetic activation of human obesity. Hypertension 2001, 38: 1316–20.

    Article  CAS  PubMed  Google Scholar 

  3. Roy MS, Roy A, Brown S. Increased Urinary-free cortisol outputs in diabetic patients. J Diabet Complications 1998, 12: 24–7.

    Article  CAS  Google Scholar 

  4. Fruehwald-Schultes B, Kern W, Bong W, et al. Supraphysiological Hyperinsulinemia acutely increases hypothalamic-pituitary-adrenal axis secretory activity in humans. J Clin Endocrinol Metab 1999, 84: 3041–6.

    Article  CAS  PubMed  Google Scholar 

  5. Appel MC, Schibly BA, Kamara JA, Sorenson RL. Adrenal gland involvement in mice with hereditary obesity and diabetes mellitus. Morphological studies. Diabetologia 1979, 16: 391–8.

    Article  CAS  Google Scholar 

  6. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997, 20: 1183–97.

    Google Scholar 

  7. Pasquali, R, Vicennati V. The abdominal obesity phenotype and insulin resistance are associated with abnormalities of the hypothalamic-pituitary-adrenal axis in humans. Horm Metab Res 2000, 32: 521–5.

    Article  CAS  PubMed  Google Scholar 

  8. Bjorntorp P, Rosmond R. Neuroendocrine abnormalities in visceral obesity. Int J Obes 2000, 24 (Suppl 2): 580–5.

    Google Scholar 

  9. Shively C, Clarkson T. Regional obesity and coronary atherosclerosis in females: a non-human primate model. Acta Med Scand 1989, 723 (Suppl): 71–8.

    Google Scholar 

  10. Rask E, Olsson T, Doderberg S, et al. Tissue-specific dysregulation of cortisol metabolism in human obesity. J Clin Endocrinol Metab 2001, 86: 1418–21.

    Article  CAS  PubMed  Google Scholar 

  11. Walker B. Activation of the hypothalamic-pituitary-adrenal axis in obesity: cause or consequence? Growth Horm IGF Res 2001, 11 (Suppl A): S91–5.

    Article  PubMed  Google Scholar 

  12. Lottenberg SA, Giannella-Neto D, Derendorf H, et al. Effect of fat distribution on the pharmacokinetics of cortisol in obesity. Int J Clin Pharmacol Ther 1998, 36: 501–5.

    CAS  PubMed  Google Scholar 

  13. Vicennati V, Pasquali R. Abnormalities of the hypothalamic-pituitary-adrenal axis in nondepressed women with abdominal obesity and relations with insulin resistance: evidence for a central and a peripheral alteration. J Clin Endocrinol Metab 2000, 85: 4093–8.

    Article  CAS  PubMed  Google Scholar 

  14. Chan O, Inouye K, Riddell MC, Vranic M, Matthews SG. Diabetes and the hypothalamo-pituitary-adrenal (HPA) axis. Minerva Endocrinol 2003, 28: 87–102.

    CAS  PubMed  Google Scholar 

  15. Pasquali R, Ambrosi B, Armanini D, et al. Cortisol and ACTH response to oral dexamethasone in obesity and effects of sex, body fat distribution, and dexamethasone concentrations: a dose-response study. J Clin Endocrinol Metab 2002, 87: 166–75.

    Article  CAS  PubMed  Google Scholar 

  16. Attia N, Tamborlane WV, Heptulla R, et al. The metabolic syndrome and insulin-like growth factor I regulation in adolescent obesity. J Clin Endocrinol Metab 1998, 83: 1467–71.

    CAS  PubMed  Google Scholar 

  17. Maccario M, Grottoli S, Procopio M et al. The GH/IGF-I axis in Obesity: Influence of neuro-endocrine and metabolic factors. Int J Obes 2000, 24 (Suppl 2): S96–9.

    Article  CAS  Google Scholar 

  18. Reincke M, Fassnacht M, Vath S, Mora P, Allolio B. Adrenal incidentalomas: a manifestation of the metabolic syndrome. Endocr Res 1996, 22: 757–61.

    CAS  PubMed  Google Scholar 

  19. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes. Diabetes Care 2001, 24: 1069–78.

    Article  CAS  PubMed  Google Scholar 

  20. Linkowski P, Mendlewicz J, Leclercq R, et al. The 24-hour profile of adrenocorticotropin and cortisol in major depressive illness. J Clin Endocrinol Metab 1985, 61: 429–38.

    Article  CAS  PubMed  Google Scholar 

  21. Amsterdam JD, Marinelli DL, Arger P, Winokur A. Assessment of adrenal gland volume by computed tomography in depressed patients and healthy volunteers: a pilot study. Psychiatry Res 1987, 21: 189–97.

    Article  CAS  PubMed  Google Scholar 

  22. Rubin RT, Phillips JJ, Sadow TF, McCracken JT. Adrenal gland volume in major depression. Increase during the depressive episode and decrease with successful treatment. Arch Gen Psychiatry 1995, 52: 213–8.

    CAS  Google Scholar 

Download references

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Correspondence to A. F. Godoy-Matos MD, MSc.

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Godoy-Matos, A.F., Vieira, A.R., Moreira, R.O. et al. The potential role of increased adrenal volume in the pathophysiology of obesity-related Type 2 diabetes. J Endocrinol Invest 29, 159–163 (2006). https://doi.org/10.1007/BF03344090

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