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Biochemistry/Physiology

Adrenomedullary function, obesity and permissive influences of catecholamines on body mass in patients with chromaffin cell tumours

International Journal of Obesity volume 43, pages 263–275 (2019)Cite this article

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Abstract

Background

Obesity-associated activation of sympathetic nervous outflow is well documented, whereas involvement of dysregulated adrenomedullary hormonal function in obesity is less clear. This study assessed relationships of sympathoadrenal function with indices of obesity and influences of circulating catecholamines on body mass.

Methods

Anthropometric and clinical data along with plasma and 24-h urine samples were collected from 590 volunteers and 1368 patients tested for phaeochromocytoma and paraganglioma (PPGL), among whom tumours were diagnosed in 210 individuals.

Results

Among patients tested for PPGL, those with tumours less often had a body mass index (BMI) above 30 kg/m2 (12 vs. 31%) and more often a BMI under 25 kg/m2 (56 vs. 32%) than those without tumours (P < 0.0001). Urinary outputs of catecholamines in patients with PPGL were negatively related to BMI (r = −0.175, P = 0.0133). Post-operative weight gain (P < 0.0001) after resection of PPGL was positively related to presurgical tumoural catecholamine output (r = 0.257, P = 0.0101). Higher BMI in men and women and percent body fat in women of the volunteer group were associated with lower plasma concentrations and urinary outputs of adrenaline and metanephrine, the former indicating obesity-related reduced adrenaline secretion and the latter obesity-related reduced adrenomedullary adrenaline stores. Daytime activity was associated with substantial increases in urinary adrenaline and noradrenaline excretion, with blunted responses in obese subjects.

Conclusions

The findings in patients with PPGL support an influence of high circulating catecholamines on body weight. Additional associations of adrenomedullary dysfunction with obesity raise the possibility of a permissive influence of the adrenal medulla on the regulation of body weight.

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Acknowledgements

We gratefully acknowledge the patients and volunteers who participated in this study, the technical assistance of Denise Kaden, Catleen Conrad and Tina Fleischer as well as assistance with patients and volunteers by Carola Kunath and Christina Pamporaki. The study was supported by grants from the Deutsche Forschungsgemeinschaft to GE and JWML (EI855/1/2, KFO252) and the European Union Seventh Framework Programme (FP7/2007-2013) to GE, FB and AS under grant agreement 259735 (ENS@T-Cancer).

Funding

This study was supported by grants from the Deutsche Forschungsgemeinschaft to GE and JWML (EI855/1/2, KFO252) and the European Union Seventh Framework Programme (FP7/2007-2013) to GE, FB and AS under grant agreement 259735 (ENS@T-Cancer). The authors declare no conflict of interests.

Author contributions:

AY, MR, SRB and GE were responsible for the study concept as well as the interpretation and analyses of data. JM, KL, TD, MF, NR-L, FB, SF AP, AJ and JL were responsible for recruitment of patients and collections of clinical data and specimens. MP and GE oversaw laboratory analyses. AS was responsible for electronic data collection. AY and GE were responsible for drafting the manuscript, after which all authors made substantive contributions to the final approved version.

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Authors and Affiliations

  1. Department of Medicine III, Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

    Yaxin An, Jimmy Masjkur, Katharina Langton, Jacques Lenders, Stefan R. Bornstein & Graeme Eisenhofer

  2. Department of Neurology, Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

    Manja Reimann

  3. Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

    Mirko Peitzsch & Graeme Eisenhofer

  4. Department of Internal Medicine, Division of Endocrinology, University Hospital, University of Würzburg, Würzburg, Germany

    Timo Deutschbein & Martin Fassnacht

  5. Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany

    Natalie Rogowski-Lehmann & Felix Beuschlein

  6. Department of Endocrinology, Diabetology and Clinical Nutrition, UnviersitätsSpital Zürich, Zurich, Switzerland

    Felix Beuschlein

  7. Department of Medicine, University Medical Center Schleswig-Holstein, Luebeck, Germany

    Stephanie Fliedner

  8. Department of Computing and Information, University of Melbourne, Melbourne, Australia

    Anthony Stell

  9. Department of Hypertension, Institute of Cardiology, Warsaw, Poland

    Aleksander Prejbisz & Andrzej Januszewicz

  10. Department of Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    Jacques Lenders

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Correspondence to Graeme Eisenhofer.

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An, Y., Reimann, M., Masjkur, J. et al. Adrenomedullary function, obesity and permissive influences of catecholamines on body mass in patients with chromaffin cell tumours. Int J Obes 43, 263–275 (2019). https://doi.org/10.1038/s41366-018-0054-9

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