{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:49:24Z","timestamp":1788587364761,"version":"build-2803163510"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT of Korea","doi-asserted-by":"publisher","award":["NRF-2020R1C1C1010723"],"award-info":[{"award-number":["NRF-2020R1C1C1010723"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Korea Health Technology R&D Project"},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Health and Welfare of the Republic of Korea","award":["HI21C0032"],"award-info":[{"award-number":["HI21C0032"]}]},{"name":"Ministry of Health and Welfare of the Republic of Korea","award":["HI22C0049"],"award-info":[{"award-number":["HI22C0049"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to examine how different types of adrenal hormone excess influence body composition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective, cross-sectional, single-centre study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively enrolled 2971 consecutive adults with adrenal tumours and age-, sex-, and body mass index\u2013matched controls at a 1:3 ratio. The area and attenuation of skeletal muscle and fat at the L3 vertebrae were measured using computed tomography\u2013based analysis software. Prevalence ratios of cardiometabolic outcomes were calculated using the Poisson regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with non-functioning adenoma (n = 1354) and mild autonomous cortisol secretion (MACS; n = 786) showed similar body compositions. Patients with overt Cushing\u2019s syndrome (CS) had the highest visceral fat (VF) area to skeletal muscle area ratio (1.14), while pheochromocytoma (PHEO) patients had the lowest (0.52). Muscle attenuation was lowest in CS and highest in PHEO (32.6 vs 41.5 Hounsfield units, P &amp;lt; .001). Mild autonomous cortisol secretion patients had higher risks of hypertension and dyslipidaemia than non-functioning adenoma patients. Non-functioning adenoma and MACS patients had higher VF area and lower muscle\/fat attenuation compared with controls, while primary aldosteronism patients had body compositions similar to controls, except for higher fat attenuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adrenal tumours are associated with altered body composition. Even patients with non-functioning adenoma and MACS had increased VF area and lower muscle and fat attenuation compared with controls, indicating potential cardiometabolic risks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvae167","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T07:51:04Z","timestamp":1740469864000},"page":"141-149","source":"Crossref","is-referenced-by-count":6,"title":["Body composition and cardiometabolic risks of patients with adrenal tumours in relation to hormonal activity: a large cross-sectional single-centre study"],"prefix":"10.1093","volume":"192","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1932-0234","authenticated-orcid":false,"given":"Jung Hee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Hospital , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Na","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital , Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital , Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Shin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Hospital , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Hee","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University College of Medicine , Seoul, Republic of Korea"},{"name":"Department of Radiology, Seoul National University Hospital , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Min","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Hospital , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Joon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University College of Medicine , Seoul, Republic of Korea"},{"name":"MEDICALIP Co. Ltd. , 9F, Yeonkang Building, 15, Jong-ro 33-gil, Seoul 03129 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University College of Medicine , Seoul, Republic of Korea"},{"name":"Department of Radiology, Seoul National University Hospital , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9003-0614","authenticated-orcid":false,"given":"Ji Won","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"issue":"11","key":"2025030419032866700_lvae167-B1","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1016\/S2213-8587(20)30314-4","article-title":"Epidemiology of adrenal tumours in Olmsted county, Minnesota, USA: a population-based cohort study","volume":"8","author":"Ebbehoj","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"11","key":"2025030419032866700_lvae167-B2","doi-asserted-by":"publisher","first-page":"3331","DOI":"10.1210\/clinem\/dgab512","article-title":"Approach to the patient with adrenal incidentaloma","volume":"106","author":"Bancos","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2025030419032866700_lvae167-B3","doi-asserted-by":"publisher","first-page":"G1","DOI":"10.1093\/ejendo\/lvad066","article-title":"European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors","volume":"189","author":"Fassnacht","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"5","key":"2025030419032866700_lvae167-B4","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/S2213-8587(13)70211-0","article-title":"Cardiovascular events and mortality in patients with adrenal incidentalomas that are either non-secreting or associated with intermediate phenotype or subclinical Cushing\u2019s syndrome: a 15-year retrospective study","volume":"2","author":"Di Dalmazi","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"2","key":"2025030419032866700_lvae167-B5","doi-asserted-by":"publisher","first-page":"107","DOI":"10.7326\/M18-3630","article-title":"Natural history of adrenal incidentalomas with and without mild autonomous cortisol excess: a systematic review and meta-analysis","volume":"171","author":"Elhassan","year":"2019","journal-title":"Ann Intern Med"},{"issue":"8","key":"2025030419032866700_lvae167-B6","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.7326\/M20-7946","article-title":"Association between mortality and levels of autonomous cortisol secretion by adrenal incidentalomas: a cohort study","volume":"174","author":"Kjellbom","year":"2021","journal-title":"Ann Intern Med"},{"issue":"3","key":"2025030419032866700_lvae167-B7","doi-asserted-by":"publisher","first-page":"325","DOI":"10.7326\/M21-1737","article-title":"Cardiometabolic disease burden and steroid excretion in benign adrenal tumors: a cross-sectional multicenter study","volume":"175","author":"Prete","year":"2022","journal-title":"Ann Intern Med"},{"issue":"8","key":"2025030419032866700_lvae167-B8","doi-asserted-by":"publisher","first-page":"533","DOI":"10.7326\/M16-0547","article-title":"\u201cNonfunctional\u201d adrenal tumors and the risk for incident diabetes and cardiovascular outcomes: a cohort study","volume":"165","author":"Lopez","year":"2016","journal-title":"Ann Intern Med"},{"issue":"12","key":"2025030419032866700_lvae167-B9","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.4158\/EP-2020-0182","article-title":"Nonfunctioning adrenal incidentalomas are not clinically silent: a longitudinal cohort study","volume":"26","author":"Kim","year":"2020","journal-title":"Endocr Pract"},{"issue":"2","key":"2025030419032866700_lvae167-B10","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1111\/jgs.12652","article-title":"Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men","volume":"62","author":"Atkins","year":"2014","journal-title":"J Am Geriatr Soc"},{"issue":"9","key":"2025030419032866700_lvae167-B11","doi-asserted-by":"publisher","first-page":"e020065","DOI":"10.1161\/JAHA.120.020065","article-title":"Associations of visceral adipose tissue and skeletal muscle density with incident stroke, myocardial infarction, and all-cause mortality in community-dwelling 70-year-old individuals: a prospective cohort study","volume":"10","author":"Ballin","year":"2021","journal-title":"J Am Heart Assoc"},{"issue":"6","key":"2025030419032866700_lvae167-B12","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1210\/jc.2012-4276","article-title":"Visceral fat accumulation and postdexamethasone serum cortisol levels in patients with adrenal incidentaloma","volume":"98","author":"Debono","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2025030419032866700_lvae167-B13","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1111\/cen.13512","article-title":"Impact of hypercortisolism on skeletal muscle mass and adipose tissue mass in patients with adrenal adenomas","volume":"88","author":"Delivanis","year":"2018","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"5","key":"2025030419032866700_lvae167-B14","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1111\/cen.13408","article-title":"Autonomous cortisol secretion in adrenal incidentalomas and increased visceral fat accumulation during follow-up","volume":"87","author":"Yener","year":"2017","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"2","key":"2025030419032866700_lvae167-B15","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1111\/cen.13902","article-title":"Changes of computed tomography-based body composition after adrenalectomy in patients with endogenous hypercortisolism","volume":"90","author":"Hong","year":"2019","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"5","key":"2025030419032866700_lvae167-B16","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1530\/EJE-21-0458","article-title":"Abnormal body composition in patients with adrenal adenomas","volume":"185","author":"Delivanis","year":"2021","journal-title":"Eur J Endocrinol"},{"key":"2025030419032866700_lvae167-B17","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1016\/j.metabol.2015.03.004","article-title":"Changes in visceral and subcutaneous fat mass in patients with pheochromocytoma","volume":"64","author":"Okamura","year":"2015","journal-title":"Metabolism"},{"key":"2025030419032866700_lvae167-B18","doi-asserted-by":"publisher","first-page":"647184","DOI":"10.3389\/fendo.2021.647184","article-title":"Evaluation of abdominal computed tomography scans for differentiating the discrepancies in abdominal adipose tissue between two major subtypes of primary aldosteronism","volume":"12","author":"Chen","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"8","key":"2025030419032866700_lvae167-B19","doi-asserted-by":"publisher","first-page":"5038","DOI":"10.1016\/j.clnu.2021.06.025","article-title":"Deep neural network for automatic volumetric segmentation of whole-body CT images for body composition assessment","volume":"40","author":"Lee","year":"2021","journal-title":"Clin Nutr"},{"issue":"2","key":"2025030419032866700_lvae167-B20","doi-asserted-by":"publisher","first-page":"246","DOI":"10.2967\/jnumed.109.068775","article-title":"CT Hounsfield units of brown adipose tissue increase with activation: preclinical and clinical studies","volume":"51","author":"Baba","year":"2010","journal-title":"J Nucl Med"},{"key":"2025030419032866700_lvae167-B21","doi-asserted-by":"publisher","first-page":"54","DOI":"10.3389\/fendo.2019.00054","article-title":"Adrenal aging and its implications on stress responsiveness in humans","volume":"10","author":"Yiallouris","year":"2019","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"7","key":"2025030419032866700_lvae167-B22","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/S2213-8587(22)00100-0","article-title":"Age-dependent and sex-dependent disparity in mortality in patients with adrenal incidentalomas and autonomous cortisol secretion: an international, retrospective, cohort study","volume":"10","author":"Deutschbein","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"12","key":"2025030419032866700_lvae167-B23","doi-asserted-by":"publisher","first-page":"3775","DOI":"10.1210\/jc.2011-1565","article-title":"Urine steroid metabolomics as a biomarker tool for detecting malignancy in adrenal tumors","volume":"96","author":"Arlt","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2025030419032866700_lvae167-B24","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1097\/MED.0000000000000153","article-title":"Adrenal adenomas, subclinical hypercortisolism, and cardiovascular outcomes","volume":"22","author":"Di Dalmazi","year":"2015","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"issue":"3","key":"2025030419032866700_lvae167-B25","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1210\/js.2018-00385","article-title":"Cyclic subclinical hypercortisolism: a previously unidentified hypersecretory form of adrenal incidentalomas","volume":"3","author":"Giorgi","year":"2019","journal-title":"J Endocr Soc"},{"issue":"17","key":"2025030419032866700_lvae167-B26","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1161\/CIRCULATIONAHA.114.015000","article-title":"Association between visceral and subcutaneous adipose depots and incident cardiovascular disease risk factors","volume":"132","author":"Abraham","year":"2015","journal-title":"Circulation"},{"issue":"4","key":"2025030419032866700_lvae167-B27","doi-asserted-by":"publisher","first-page":"482","DOI":"10.4093\/dmj.2020.0277","article-title":"Computed tomography-derived myosteatosis and metabolic disorders","volume":"45","author":"Miljkovic","year":"2021","journal-title":"Diabetes Metab J"},{"key":"2025030419032866700_lvae167-B28","doi-asserted-by":"publisher","first-page":"110752","DOI":"10.1016\/j.nut.2020.110752","article-title":"Low-attenuation muscle is a predictor of diabetes mellitus: a population-based cohort study","volume":"74","author":"Tanaka","year":"2020","journal-title":"Nutrition"},{"issue":"2","key":"2025030419032866700_lvae167-B29","doi-asserted-by":"publisher","first-page":"e788","DOI":"10.1210\/clinem\/dgad520","article-title":"Subtype-specific body composition and metabolic risk in patients with primary aldosteronism","volume":"109","author":"Park","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2025030419032866700_lvae167-B30","doi-asserted-by":"publisher","first-page":"e230043","DOI":"10.1530\/EC-23-0043","article-title":"Autonomous cortisol secretion in patients with primary aldosteronism: prevalence and implications on cardiometabolic profile and on surgical outcomes","volume":"12","author":"Araujo-Castro","year":"2023","journal-title":"Endocr Connect"},{"issue":"4","key":"2025030419032866700_lvae167-B31","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1210\/jc.2012-3625","article-title":"Changes in energy metabolism in pheochromocytoma","volume":"98","author":"Petrak","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2025030419032866700_lvae167-B32","doi-asserted-by":"publisher","first-page":"e21006","DOI":"10.1371\/journal.pone.0021006","article-title":"Brown adipose tissue in humans is activated by elevated plasma catecholamines levels and is inversely related to central obesity","volume":"6","author":"Wang","year":"2011","journal-title":"PLoS One"},{"issue":"3","key":"2025030419032866700_lvae167-B33","doi-asserted-by":"publisher","first-page":"450","DOI":"10.7326\/M21-4526","article-title":"Cardiometabolic morbidity of mild cortisol excess","volume":"175","author":"Lacroix","year":"2022","journal-title":"Ann Intern Med"},{"issue":"1","key":"2025030419032866700_lvae167-B34","doi-asserted-by":"publisher","first-page":"10","DOI":"10.7326\/M20-0065","article-title":"The unrecognized prevalence of primary aldosteronism: a cross-sectional study","volume":"173","author":"Brown","year":"2020","journal-title":"Ann Intern Med"}],"container-title":["European Journal of Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejendo\/article-pdf\/192\/2\/141\/62193275\/lvae167.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejendo\/article-pdf\/192\/2\/141\/62193275\/lvae167.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T16:00:09Z","timestamp":1741104009000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/192\/2\/141\/8044830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,1]]},"references-count":34,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ejendo\/lvae167","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2025,2,1]]}}}