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While the adrenal cortex secretes glucocorticoids and mineralocorticoids that influence AT distribution, lipid storage, and browning, the adrenal medulla releases catecholamines that acutely activate thermogenesis in brown and beige adipocytes. Under physiological conditions, this bidirectional crosstalk maintains energy homeostasis and cardiovascular stability. However, in adrenal diseases such as Cushing syndrome, primary aldosteronism, adrenocortical carcinoma, or pheochromocytoma, excess hormone secretion disrupts this balance, leading to AT dysfunction, altered adipokine secretion, and adverse metabolic profiles, including insulin resistance, visceral adiposity, and hypertension. Emerging evidence suggests that peri-adrenal AT may modulate adrenal tumor biology through endocrine and paracrine signals, and immune cell infiltration, with potential effects on disease progression and clinical presentation. Uncovering cellular and molecular mechanisms underlying the crosstalk between adrenal gland and AT may reveal new therapeutic targets for the reduction of cardiometabolic complications in patients with adrenal disorders. Here, we discuss how 2 endocrine organs\u2014adrenal gland and AT\u2014interact with each other under physiological and pathophysiological conditions and examine whether these interactions influence the progression of adrenal tumors and how this affects systemic metabolic health.<\/jats:p>","DOI":"10.1093\/ejendo\/lvaf252","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T13:10:22Z","timestamp":1765285822000},"page":"R83-R96","source":"Crossref","is-referenced-by-count":2,"title":["Adrenal\u2013adipose tissue crosstalk in health and disease"],"prefix":"10.1093","volume":"193","author":[{"given":"Mingyan","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , 01307 Dresden ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Stifel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, University Medical Center , 89081 Ulm ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Bl\u00fcher","sequence":"additional","affiliation":[{"name":"German Center for Diabetes Research , 85764 Neuherberg ,","place":["Germany"]},{"name":"Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Center Munich, University of Leipzig and University Hospital Leipzig , 04108 Leipzig ,","place":["Germany"]},{"name":"Department of Endocrinology, Nephrology, Rheumatology, University Hospital Leipzig , 04103 Leipzig 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