The effect of endogenous cortisol excess on perivascular, renal sinus, intramuscular, liver and pancreatic fat quantity

Bilger N, The Effect of Endogenous Cortisol Excess on Perivascular, Renal Sinus, Intramuscular, Liver and Pancreatic Fat Quantity, Gazi University Faculty of Medicine, Department of Internal Medicine, Ankara 2021. Endogenous cortisol excess is known to affect body fat distribution. Ectopic fat is the accumulation of triglycerides in non-adipose tissue regions that normally contain little fat. The aim of study is to investigate the amount of ectopic fat in intra-abdominal organs and tissues of patients with endogenous cortisol excess and its relationship with their comorbitidies and laboratory findings. Our study included 16 patients with pituitary Cushing's Disease (CD), 21 patients with adrenal Cushing's Syndrome, 34 patients with mild autonomous cortisol excess, 48 patients with non-functioning adrenal adenomas. Perivascular, renal sinus fat, liver, pancreas, intramuscular fat distributions in MRI of the patients were evaluated retrospectively. It was determined that the amount of perivascular fat was increased in patients with CD (p=0,01). In whole group, there was a positive relationship between the amount of perivascular fat and triglyceride levels, cortisol levels after 1 mg dexamethasone suppression test, male gender (p<0,05). Altough the amount of adiposity was higher in CD, there were no differences between the groups in amounts of renal sinus, liver, pancreas and intramuscular fat (p>0,05). Patients with Diabetes Mellitus had a increased amount of renal sinus fat (p=0,008). Perivascular fat was positively correlated with renal sinus fat and percentage of liver signal intensity loss (p<0,05). In conclusion, the excess of endogenous cortisol might be increasing the amount of ectopic fat especially in the perivascular tissue, which might related with the degree of metabolic disorder caused by the disease.