ECEESPE2025 Poster Presentations Pituitary, Neuroendocrinology and Puberty (162 abstracts)
Circulating vitamin D levels predict the occurrence of vertebral fractures in patients with cushing’s disease
Sabrina Chiloiro 1 , Miriam Veleno 1 , Ginevra D’Onofrio 1 , Antonella Giampietro 1 , Amato Infante 1 , Elena Ricciardi 1 , Diana Broglia 1 , Consolato Gullì 1 , Pier Paolo Mattogno 1 , Quintino Giorgio De Alessandris 1 , Liverana Lauretti 1 , Alessandro Olivi 1 , Laura De Marinis 1 , Antonio Bianchi 1 , Alfredo Pontecorvi 1 & Francesco Doglietto 1
1Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
JOINT2562
Context: Skeletal fragility is a clinically relevant complication of Cushing’s disease, occurring in 15%-78% of patients. Limited studies are available on predictors of vertebral fractures. Here, we investigated the correlations between occurrence of incidental VFs (i-VFs) and serum V25OH-D concentrations, before and during cholecalciferol supplementation.
Patients and methods: A longitudinal and retrospective study was performed on patients affected by Cushing’s disease, treated and untreated with D3 supplementation. The primary objective of the study was to investigate the correlations between the occurrence of VFs and serum V25OH-D concentrations.
Results: Out of 159 patients diagnosed for Cushing’s disease at our center, 26 patients were included. At baseline, the median serum V25OH-D level was 21.1 ng/mL (IQR: 17) in the whole study population. Six patients were affected by osteopenia/osteoporosis (23.1%), and 4 patients carried prevalent VFs (15.4%). The median serum V25OH-D concentration was 20.3 (IQR: 27) ng/mL in patients without osteopenia/osteoporosis and was 24.9 (IQR: 15.7) ng/mL in patients with osteopenia/osteoporosis (P = 0.648). The median serum V25OH-D concentration was 22.1 (IQR: 16) ng/mL in patients without prevalent VFs and was 11.3 (IQR: 34) ng/mL in patients with prevalent VFs (P = 0.166). Eleven patients were treated with D3 supplementation (42.3%). Serum V25OH-D levels at baseline were slightly but not significantly lower in D3 treated vs untreated patients (20.3 IQR: 27.3 vs. 22 IQR: 18 ng/mL; P = 0.61). The median D3 weekly dosage was 12500 IU (IQR: 14500), median duration of D3 supplementation was 37 months (IQR: 26). No adverse events related to D3 supplementation were reported by patients or identified from medical records. At last follow-up, seven patients developed incidental VFs (26.9%): three patients were on D3-supplementation (42.9%), and four were not on D3-supplementation (57.1%; P = 0.665). Final serum V25OH-D level was lower in patients with i-VFs (28.6 ng/mL, IQR:4.1) as compared to patients without i-VFs (34.2 ng/mL, IQR:9.6; P = 0.007). Patients with i-VFs had lower V25OH-D levels before starting D3 supplementation (11.6 ng/mL IQR:10), then patients without i-VFs (24.9 ng/mL IQR:25.3, P = 0.003). I-VFs occurred more frequently in males (57.1%) then in females (42.9%, P = 0.047). The logistic regression confirmed the protective role of V25OH-D levels >12 ng/mL before D3-supplementation (OR: 0.07 95%IC:0.01-0.58 P = 0.05), of V25OH-D levels >35 ng/mL during follow-up; and the not-protective role of the male gender (OR: 1.5 95%IC:1.1-2.4 P = 0.008).
In Conclusion: Our study proved that D3-supplementation should be consider in patients affected by Cushing’s disease to reach circulating V25OH-D levels protective for the occurrence of i-VFs.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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