Obesity Might Persistently Increase Adrenal Gland Volume: a Preliminary Study

This study aimed to investigate the association of obesity with adrenal gland volume (AGV) and the effects of weight loss on AGV.

This study included obese patients (N = 25) who underwent sleeve gastrectomy and age- and sex-matched healthy volunteers (HVs) (N = 25) and overweight healthy volunteers (overweight-HVs) (N = 21). Thin-slice computed tomography was used to evaluate adrenal morphological changes. AGV was measured semiautomatically based on the digital imaging and communications in medicine (DICOM) image. The effects of weight loss on AGV and adrenal gland density were evaluated in patients for 1 year or more after sleeve gastrectomy.

Left, right, and total AGV were 6.77 ± 0.36, 5.76 ± 0.31, and 12.53 ± 0.64 cm³ in obese patients, which were significantly higher than those in the overweight-HVs (3.88 ± 0.14, 3.09 ± 0.13, and 6.97 ± 0.24 cm³) and HVs (3.38 ± 0.23, 2.67 ± 0.15, and 6.04 ± 0.36 cm³). AGV was larger in overweight-HVs than in HVs, but no statistically significant difference was identified. Sleeve gastrectomy significantly reduced body weight (- 27.1 ± 2.5 kg), left AGV (- 0.80 ± 0.26 cm³), and right AGV (- 0.88 ± 0.20 cm²). The adrenal volume in five patients was not reduced, despite significant weight loss postsurgery. The mean density of adrenal glands was lower in obese patients (P = 0.025) but were not significantly increased postsurgery.

Obesity leads to increased AGV, and in some cases, this effect seems to be irreversible. The clinical implication of obesity-induced adrenal morphological changes needs to be studied further.