ECE2006 Oral Communications Calcium and bone OC49 Novartis Oncology Young Investigator Award (8 abstracts)
Bone involvement in patients with adrenal incidentalomas: role of subclinical hypercortisolism
I Chiodini , F Coletti , P Epaminonda , S Di Lembo , V Morelli , B Masserini , G Adda & M Arosio
Unit of Endocrinology, San Giuseppe-Fatebenefratelli Hopital, AFaR, Milan, Italy.
Previous studies suggest that in patients with adrenal incidentalomas (AI) subclinical hypercortisolism (SH) exerts a deleterious effect on bone mineral density (BMD), but scarce data are available about vertebral fractures. We evaluate BMD and prevalence of vertebral fractures in a sample of AI subjects with and without SH.
Forty-seven consecutive AI inpatients were evaluated (17M, 30F). The patients were subdivided into two groups: with or without subclinical hypercortisolism (SH+/SH−). The diagnosis of SH was made on the presence of 2 of the following 3 alterations in the pituitary-adrenal axis: urinary free cortisol (UFC) levels higher than 70 mcg/24 hrs, serum cortisol levels after a 1-mg overnight dexamethasone suppression test (F after Dex) higher than 3.0 mcg/dL, and ACTH levels lower than 10 pg/mL. In all patients spinal and femoral BMD was measured by DXA and expressed as Z-score (LS Z-score, FN Z-score respectively). Results are shown in Table 1.
| SH+ (n=14) | SH− (n=33) | |
| Age (Yrs) | 71.6±11.1 | 67.3±10 |
| Gender (M/F) | 6/8 | 11/22 |
| Diameter of adenoma (cm) | 2.04±0.88 | 2.46±0.42 |
| BMI (Kg/m2) | 28.1±4.7 | 27.9±7.1 |
| Prevalence of osteoporosis (%) | 20 | 15 |
| Z-score LS (g/cm2) | −0.89±1.092 | 0.184±0.894 |
| Z-score FN (g/cm2) | −0.20±0.602 | 0.342±0.948 |
| Vertebral Fractures: (%) | 88.9* | 16.7 |
| Data are mean±S.D.; *P=0.001. In the logistic regression analysis, significant predictor of vertebral fracture was F-Dex (OR 0.024,CI 95% 0.002–0.315, P=0.005) but not age and BMI. | ||
In patients with adrenal incidentalomas, SH is associated to a higher prevalence of vertebral fractures related to the degree of cortisol secretion. Bone involvement has to be evaluated in AI patients with SH.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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