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. 2022 Apr 13;14(8):1967.
doi: 10.3390/cancers14081967.

Change of Computed Tomography-Based Body Composition after Adrenalectomy in Patients with Pheochromocytoma

Yousun Ko  1 , Heeryoel Jeong  2 , Seungwoo Khang  2 , Jeongjin Lee  2 , Kyung Won Kim  3 , Beom-Jun Kim  4
Affiliations

Change of Computed Tomography-Based Body Composition after Adrenalectomy in Patients with Pheochromocytoma

Yousun Ko et al. Cancers (Basel). .

Abstract

Despite the potential biological importance of the sympathetic nervous system on fat and skeletal muscle metabolism in animal and in vitro studies, its relevance in humans remains undetermined. To clarify the influence of catecholamine excess on human body composition, we performed a retrospective longitudinal cohort study including 313 consecutive patients with histologically confirmed pheochromocytoma who underwent repeat abdominal computed tomography (CT) scans before and after adrenalectomy. Changes in CT-determined visceral fat area (VFA), subcutaneous fat area (SFA), skeletal muscle area (SMA), and skeletal muscle index (SMI) were measured at the level of the third lumbar vertebra. The mean age of all patients was 50.6 ± 13.6 years, and 171/313 (54.6%) were women. The median follow-up duration for repeat CTs was 25.0 months. VFA and SFA were 14.5% and 15.8% higher, respectively (both p < 0.001), after adrenalectomy, whereas SMA and SMI remained unchanged. Similarly, patients with visceral obesity significantly increased from 103 (32.9%) at baseline to 138 (44.1%) following surgery (p < 0.001); however, the prevalence of sarcopenia was unchanged. This study provides important clinical evidence that sympathetic hyperactivity can contribute to lipolysis in visceral and subcutaneous adipose tissues, but its impact on human skeletal muscle is unclear.

Keywords: body composition; catecholamine excess; obesity; pheochromocytoma; sarcopenia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Changes in computed tomography-determined body compositions including visceral fat area (A), subcutaneous fat area (B), skeletal muscle area (C), and skeletal muscle index (D), before and after adrenalectomy in patients with pheochromocytoma. All p-values were calculated using the paired t-test or Wilcoxon signed-rank test, as appropriate. ADX, adrenalectomy.
Figure 2
Figure 2
Representative image for body composition measurement using automated artificial intelligence software AID-UTM (iAID inc, Seoul, Korea). Subcutaneous fat area (SFA; brown) and visceral fat area (VFA; purple) increased following adrenalectomy (ADX), whereas skeletal muscle area (SMA; red) statistically remained unchanged. These findings were observed in 266 out of 313 patients (85.0%).
Figure 3
Figure 3
Changes in the prevalence of computed tomography-determined visceral obesity (A), sarcopenia based on skeletal muscle area (B), and skeletal muscle index (C) before and after adrenalectomy in patients with pheochromocytoma. All p-values were calculated using McNemar’s test for paired proportions. ADX, adrenalectomy; SMA, skeletal muscle area; SMI, skeletal muscle index.
See this image and copyright information in PMC

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