The Impact of Mild Autonomous Cortisol Secretion on Bone Turnover Markers.

The Journal of Clinical Endocrinology and Metabolism
Shobana AthimulamIrina Bancos

Abstract

Several studies have reported increased risk of fragility fractures in patients with mild autonomous cortisol secretion (MACS), discordant to the degree of bone density deterioration. To evaluate the effect of MACS on bone metabolism in patients with adrenal adenomas. Cross-sectional study with prospective enrollment, 2014-2019. Referral center. 213 patients with adrenal adenomas: 22 Cushing syndrome (CS), 92 MACS and 99 nonfunctioning adrenal tumors (NFAT). Osteocalcin, procollagen I intact N-terminal (PINP), C-terminal telopeptide (CTX), sclerostin. Patients with CS demonstrated lower markers of bone formation compared with patients with MACS and NFAT (CS vs MACS vs NFAT: mean osteocalcin 14.8 vs 20.1 vs 21.3 ng/mL [P < 0.0001]; mean PINP 34.8 vs 48.7 vs 48.5 µg/L [P = 0.003]). Severity of cortisol excess was inversely associated with sclerostin (CS vs MACS vs NFAT: mean sclerostin 419 vs 538 vs 624 ng/L, [P < 0.0001]). In a multivariable model of age, sex, body mass index, cortisol, and bone turnover markers, sclerostin was a significant predictor of low bone mass in patients with MACS (OR 0.63 [CI 95%, 0.40-0.98] for each 100 ng/L of sclerostin increase).After adrenalectomy, osteocalcin, CTX, and sclerostin increased by a m...Continue Reading

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Citations

Apr 27, 2020·Journal of Endocrinological Investigation·P Szulc
Sep 3, 2020·The Journal of Clinical Endocrinology and Metabolism·Guido Di DalmaziCristina L Ronchi
Feb 17, 2021·Best Practice & Research. Clinical Endocrinology & Metabolism·Shobana AthimulamIrina Bancos
May 24, 2021·Endocrinology and Metabolism Clinics of North America·Sumeet Jain
May 24, 2021·Endocrinology and Metabolism Clinics of North America·Guido Zavatta, Bart L Clarke
Aug 14, 2020·Current Pharmaceutical Design·Miomira IvovićSvetlana Vujović
Oct 29, 2021·Der Internist·Anna Riester, Felix Beuschlein

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