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Cited by 69Bone health and osteoporosis researchAdrenal and Paraganglionic TumorsAdrenal Hormones and Disorders

Bone loss rate in adrenal incidentalomas: a longitudinal study

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Chiodini, Iacopo, Torlontano, Massimo, Carnevale, Vincenzo, Guglielmi, Giuseppe, Cammisa, Mario, Trischitta, Vincenzo, Scillitani, A.·2001·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem.86.11.8022
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Abstract

Although by definition patients with adrenal incidentalomas (AI) do not have evident clinical syndromes, they may frequently suffer from subclinical hypercortisolism (SH). This is of some importance because of evidence that SH may lead to clinical complications, including bone loss. Thus, the understanding of bone involvement due to SH may be extremely important in the management of AI. Unfortunately, the available data on bone mineral density (BMD) in AI patients come from cross-sectional studies, which, to further complicate our understanding, are also conflicting, probably due to a different selection of patients and/or the variability in cortisol secretion (CS) often described in AI. To gain further insight about this topic, we performed a longitudinal study evaluating the rate of spinal and femoral bone loss levels in 24 females with AI. AI subjects were subdivided in two groups on the basis of the median of urinary cortisol secretion (UFC): group I (n = 12; UFC, <140.4 nmol/24 h) and group II (n = 12; UFC, >140.4 nmol/24 h). Spinal BMD was measured by both single energy quantitative computed tomography (L1-L4) and dual energy x-ray absorptiometry (DXA; L2-L4), and femoral BMD was determined by DXA. Bone loss rate was expressed as the change in z-score per yr. The spinal bone loss rate was higher (P < 0.005) in group II than in group I when measured by both quantitative computed tomography (-0.19 +/- 0.14 vs. 0.00 +/- 0.15) and DXA (-0.19 +/- 0.17 vs. 0.00 +/- 0.11). Moreover, CS and spinal bone loss rate were significantly correlated when patients were considered together. In conclusion, our data show that 1) AI patients with higher CS have increased lumbar trabecular bone loss rate than those with lower CS; and 2) the degree of spinal bone loss rate is related to the degree of CS. Thus, lumbar spine (LS) BMD has to be evaluated for well balanced decision-making on the treatment of choice for AI female patients.

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Authors
Chiodini, I., Torlontano, M., Carnevale, V., Guglielmi, G., Cammisa, M., Trischitta, V., & Scillitani, A.
Affiliations
Casa Sollievo della Sofferenza (IT)
Corresponding author
Scillitani, A.
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2001-11
Volume
86
Issue
11
Pages
5337-5341
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem.86.11.8022
OpenAlex
W2071760720
Cited by
69
References
31
Citations by year
2024: 6 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 6 · 2018: 2 · 2016: 3 · 2015: 2 · 2014: 2 · 2013: 2 · 2012: 5
FWCI
2.65
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
adrenal incidentaloma, bone loss rate, subclinical hypercortisolism, bone mineral density, urinary free cortisol, lumbar spine, femoral bone density, trabecular bone loss, cortisol secretion, women
MeSH terms
Adrenal Gland Neoplasms, Adult, Aged, Female, Femur, Hormones, Humans, Hydrocortisone, Longitudinal Studies, Menopause, Menstrual Cycle, Middle Aged, Spine, Bone Density

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