The Effect of Biochemical Remission on Bone Metabolism in Cushing's Syndrome: A 2-Year Follow-Up Study

Braun, Leah; Reincke, Martín

doi:10.1002/jbmr.4309

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…This result suggested that the diminished hGRH-induced GH secretion in patients with Cushing's syndrome might be caused by the prolonged period of hypercortisolemia [ 12 ]. Other surveys indicated that glucocorticoids, suppressing GH–IGF-1 and the hypothalamic-pituitary-gonadal axes, lead to decreased number and dysfunction of osteoblast [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Association of IGF-1 Level with Low Bone Mass in Young Patients with Cushing’s Disease

Sun

Cui

et al. 2023

International Journal of Endocrinology

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Purpose. Few related factors of low bone mass in Cushing’s disease (CD) have been identified so far, and relevant sufficient powered studies in CD patients are rare. On account of the scarcity of data, we performed a well-powered study to identify related factors associated with low bone mass in young CD patients. Methods. This retrospective study included 153 CD patients (33 males and 120 females, under the age of 50 for men and premenopausal women). Bone mineral density (BMD) of the left hip and lumbar spine was measured by dual energy X-ray absorptiometry (DEXA). In this study, low bone mass was defined when the Z score was −2.0 or lower. Results. Among those CD patients, low bone mass occurred in 74 patients (48.37%). Compared to patients with normal BMD, those patients with low bone mass had a higher level of serum cortisol at midnight (22.31 (17.95-29.62) vs. 17.80 (13.75-22.77), p = 0.0006 ), testosterone in women (2.10 (1.33–2.89) vs. 1.54 (0.97–2.05), p = 0.0012 ), higher portion of male (32.43% vs. 11.54%, p = 0.0016 ) as well as hypertension (76.12% vs. 51.67%, p = 0.0075 ), and lower IGF-1 index (0.59 (0.43–0.76) vs. 0.79 (0.60–1.02), p = 0.0001 ). The Z score was positively associated with the IGF-1 index in both the lumbar spine (r = 0.35153, p < 0.0001 ) and the femoral neck (r = 0.24418, p = 0.0057 ). The Z score in the femoral neck was negatively associated with osteocalcin (r = −0.22744, p = 0.0229 ). Compared to the lowest tertile of the IGF-1 index (<0.5563), the patients with the highest tertile of the IGF-1 index (≥0.7993) had a lower prevalence of low bone mass (95% CI 0.02 (0.001–0.50), p = 0.0002 ), even after adjusting for confounders such as age, gender, duration, BMI, hypertension, serum cortisol at midnight, PTH, and osteocalcin. Conclusions. The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.

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Section: Introductionmentioning

confidence: 99%

Association of IGF-1 Level with Low Bone Mass in Young Patients with Cushing’s Disease

Sun

Cui

et al. 2023

International Journal of Endocrinology

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Possible, probable, and certain hypercortisolism: A continuum in the risk of comorbidity

Araujo‐Castro¹,

Pascual‐Corrales²,

Lamas³

2023

Annales d'Endocrinologie

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Mild autonomous cortisol secretion in adrenal incidentalomas and risk of fragility fractures: a large cross-sectional study

Zavatta

Vicennati

Altieri

et al. 2023

European Journal of Endocrinology

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Objective Mild autonomous cortisol secretion (MACS) has been associated with a higher prevalence of osteoporosis, although most data rely on single-center studies with limited sample size. We aimed to assess the prevalence of fragility fractures and contributing factors in a large cohort of patients with adrenal incidentalomas. Design and Methods Medical records of 1023 patients with adrenal incidentalomas from 1990 to 2019 were reviewed, and 735 patients were selected. Clinically-obtained electronic radiological images closest to first endocrine evaluation, such as lateral views of spine X-rays or CT thoraco-abdominal scans, were reviewed to screen for asymptomatic morphometric vertebral fractures. Clinical fragility fractures, hormonal and DXA indices were also recorded. Results 474 patients had non-functioning (NF) adrenal incidentalomas, 238 had MACS and 23 Adrenal Cushing’s Syndrome (AC). Prevalence of fragility fractures was different (P = 0.018) between groups, respectively 24.1% (NF), 34.0% (MACS) and 30.4% (AC), with significant difference between NF and MACS (P = 0.012). When analyzed separately by sex and menopausal status, this difference remained significant in post-menopausal women (P = 0.011), with a fracture prevalence of 22.2% (NF), 34.6% (MACS). Fracture prevalence was similar in males. Women with MACS aged ≥65 years reported a 48.8% prevalence of fractures, as compared with 29.5% in NF (P < 0.01). In post-menopausal women, fragility fractures were associated with age (OR 1.1, P < 0.001), smoking (OR 1.8, P = 0.048) and 1mg-DST cortisol (OR 3.1, P = 0.029), while in men, only age was associated with fragility fractures. Conclusions A considerable fracture burden was shown in post-menopausal women with adrenal incidentalomas and MACS, with clinical implications for the evaluation and management of bone metabolism.

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The Effect of Biochemical Remission on Bone Metabolism in Cushing's Syndrome: A 2-Year Follow-Up Study

Cited by 3 publications

References 28 publications

Association of IGF-1 Level with Low Bone Mass in Young Patients with Cushing’s Disease

Association of IGF-1 Level with Low Bone Mass in Young Patients with Cushing’s Disease

Possible, probable, and certain hypercortisolism: A continuum in the risk of comorbidity

Mild autonomous cortisol secretion in adrenal incidentalomas and risk of fragility fractures: a large cross-sectional study

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