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Cited by 34Adrenal Hormones and DisordersBone health and osteoporosis researchHormonal Regulation and Hypertension

Suppressed Levels of Serum Cortisol Following High-Dose Oral Dexamethasone Administration Differ between Healthy Postmenopausal Females and Patients with Established Primary Vertebral Osteoporosis

Kann, P., Laudes, M., Piepkorn, B., Heintz, A., Beyer, J.·2001·Clinical Rheumatology
DOI 10.1007/s100670170099
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Abstract

Hypercortisolism and glucocorticoid treatment, even in a low dose or administered topically, may influence bone metabolism. It was the aim of this study to investigate whether there might be differences in the regulation of endogenous cortisol secretion between patients with established primary vertebral osteoporosis and healthy controls. Suppressed morning serum cortisol concentrations in a 3 mg dexamethasone overnight suppression test were compared in well-defined healthy postmenopausal women (n = 149) and osteoporotic patients classified as having established primary vertebral osteoporosis with no clinical features of hypercortisolism (n = 78). Suppressed cortisol in the healthy controls was 1.08 +/- 0.44 microg/dl and in the primary osteoporotics 1.58 +/- 1.42 microg/dl (p < 0.0001). Of the investigated primary osteoporotics 15.4% (n = 12) had suppressed cortisol levels above the 97.5th percentile (1.96 microg/dl) of the healthy controls. Subgroup analysis regarding the influence of gonadal steroid hormone replacement in both groups and gender in the osteoporotic group did not change the results. Four of the 12 patients with incomplete suppressive cortisol underwent adrenal endosonography, unilateral adrenal nodular hyperplasia being detected in three cases. In two patients the diagnosis was confirmed by histology and normalisation of a dexamethasone suppression test following endoscopic adrenalectomy. These data yield evidence for a difference in the regulation of cortisol secretion following high-dose dexamethasone administration between healthy subjects and a subgroup of patients with primary osteoporosis. This might be due to a relevant amount of autonomous cortisol secretion in some of these patients; however, even cortisol resistance has to be taken into account.

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  • In assessing the HPA axis by 3-mg dexamethasone suppression testing with a sensitive cutoff, a 3.8% prevalence of subclinical hypercortisolism was found in osteoporosis, all of adrenal origin.

    “In assessing the HPA axis by 3-mg DST with a sensitive cutoff, a 3.8% prevalence of SH was found; all cases were of adrenal origin (90).”

    From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [90]

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Authors
Kann, P., Laudes, M., Piepkorn, B., Heintz, A., & Beyer, J.
Affiliations
University Medical Center of the Johannes Gutenberg University Mainz (DE)
ORCID
Laudes, M.
Venue
Clinical Rheumatology
Publisher
Springer Science and Business Media LLC
Published
2001-01-01
Volume
20
Issue
1
Pages
25-29
ISSN
  • 0770-3198 (ISSN-L)
  • 1434-9949
DOI
10.1007/s100670170099
OpenAlex
W1972143225
Cited by
34
References
21
Citations by year
2025: 1 · 2024: 1 · 2021: 3 · 2019: 2 · 2018: 1 · 2016: 2 · 2015: 2 · 2014: 3 · 2013: 5 · 2012: 3
FWCI
0.23
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Clinical Rheumatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Keywords
serum cortisol, dexamethasone suppression test, hypercortisolism, glucocorticoid-induced osteoporosis, adrenal nodular hyperplasia, autonomous cortisol secretion, cortisol resistance, postmenopausal women, endoscopic adrenalectomy
MeSH terms
Aged, Anti-Inflammatory Agents, Dexamethasone, Female, Humans, Hydrocortisone, Male, Middle Aged, Osteoporosis, Spinal Diseases, Osteoporosis, Postmenopausal

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