The aim of the present study was to compare the assessment of BMD measured either by DEXA or by QUS in patients with AI. We evaluated 40 patients with AI, who underwent an evaluation of hypothalamic-pituitary-adrenal (HPA) axis function and bone densitometry measured either by DEXA (Hologic QDR 4500 W) at lumbar spine and at femur or QUS (Achilles Express) at the right foot. Subclinical Cushings syndrome (SCS) was defined as abnormal response to at least 2 standard tests of the HPA axis function in the absence of clinical signs of glucocorticoid excess. The measurement of BMD by DEXA either at lumbar spine or at femur was strongly correlated with stiffness value obtained by QUS. The patients classified as osteopenic or osteoporotic (WHO criteria) were 25/40 by using DEXA at lumbar spine and 26/40 by using QUS. These patients showed both lower BMI and DHEAS levels than subjects with normal BMD. The comparison between the two techniques in each subjects demonstrated a concordant result in 77.5% of patients. In a multiple regression model, either lumbar spine BMD or QUS were associated only with DHEAS levels, whereas there was a positive correlation between femur BMD with both DHEAS and BMI and a negative correlation with cortisol levels after 1 mg dexamethasone suppression test. The 13 patients with SCS were older than the remainder, but we did not observe any significant differences for BMD value measured either by DEXA or by QUS. In these preliminary data QUS measurement presents a good correlation with DEXA technique and seems to be a reliable tool for the detection of bone alteration in subjects with adrenal incidentaloma also in patients with SCS. Moreover, in patients with AI lower DHEAS levels and BMI values appear to have a main role in the pathogenesis of osteopenia or osteoporosis.
01 - 05 Apr 2006
European Society of Endocrinology