ArticleJournal of endocrinological investigation2026
Worse muscle mass loss in adrenal Cushing syndrome vs. Cushing's disease: a comparative evaluation of chemiluminescence and LC-MS/MS cortisol assessment.
Article in Journal of endocrinological investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeMuscle mass loss is a serious complication of Cushing's syndrome. This study aims to compare muscle mass loss between two subtypes of Cushing's syndrome and to evaluate the clinical value of comprehensive LC-MS/MS steroid profiling alongside chemiluminescence (CL).
methodIn a retrospective cohort of 78 premenopausal women (37 Cushing's disease [CD] and 41 adrenal Cushing syndrome [ACS]), clinical features, muscle mass, and 11 steroid hormones were compared. In addition, the independent associations between muscle mass index (appendicular skeletal muscle mass/height squared, ASM/height
resultThe serum and urinary cortisol, serum ACTH, testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone-sulphate and cortisone concentrations with CD were higher than those with ACS, and the muscle mass with CD was also higher compared with ACS. In the fully adjusted multivariable linear regression model, serum cortisol maintained a negative trend with ASM/height
conclusionIn premenopausal women, the muscle mass with CD is significantly higher than that with ACS. This may indicate a higher severity of myopathy in ACS patients. Muscle wasting in Cushing's syndrome represents a multifactorial process driven by mechanical load, subtype-specific androgen status, and cortisol exposure. Furthermore, CL cortisol offers a reliable, accessible first-line assessment tool, while LC-MS/MS provides added value through multi-steroid profiling.
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