Osteoporosis Is More Prevalent in Adrenal than in Pituitary Cushing's Syndrome.
Open accessAbstract
Osteoporosis is the most common complication of Cushing's syndrome. We retrospectively examined the prevalence and risk factors for osteoporosis in 42 female patients with Cushing's syndrome. Osteoporosis and atraumatic fractures were assessed by bone mineral density of the lumbar vertebral spine (L2-L4) using dual energy X-ray absorptiometry (DXA) and X-ray examination. The prevalence of osteoporosis and fracture were 54.8% and 21.4%, respectively. The prevalence of osteoporosis (69.6% vs. 37.8%) and atraumatic bone fracture (26.1% vs. 15.8%) were significantly higher in patients with adrenal Cushing's than in those with pituitary Cushing's. AP and lateral BMD was significantly higher in patients with pituitary origin than in those with adrenal origin. Among several variables examined by multiple logistic regression, the etiology of Cushing's syndrome (adrenal vs. pituitary origin) was a significant factor affecting the prevalence of osteoporosis. Neither age, body mass index, duration of amenorrhea, nor extent of hypercortisolism were significant factors in this analysis. Plasma DHEA-S and urinary 17-KS excretion were significantly higher in pituitary Cushing's than in adrenal Cushing's. The present study shows that the prevalence of osteoporosis in patients with Cushing's syndrome is influenced by its etiology. A factor associated with pituitary Cushing's syndrome, such as adrenal androgen, may protect these patients from glucocorticoid-induced osteoporosis.
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The prevalence of osteoporosis and atraumatic fractures is higher in adrenal Cushing's syndrome than in pituitary Cushing's syndrome.
“The prevalence of osteoporosis and atraumatic fractures is higher in adrenal Cushing's syndrome than in pituitary Cushing's syndrome [11].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [11]
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References 22 · Cited by 81
Research works printed but not linked: 5
- [1]1. Cushing H (1932) The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophillism). Bulletin of Johns Hopkins Hospital 50: 137-195.
- [3]3. Lukert BP (1996) Glucocorticoid-induced osteoporosis. In: Marcus R, Feldman D, Kelsey J (eds), Osteoporosis, Academic Press, San Diego 801–820.
- [7]7. Tomita A, Kawakubo A, Yoneda M, Oiso Y, Takatsuki K (1988) Osteoporosis and calcium metabolism in Cushing's syndrome. In: Takeda R, Miyamori I (eds) Controversies in Disorders of Adrenal Hormones, Elsevier Science Pub BV, Amsterdam 43-47.
- [12]12. Japanese Society of Bone Mineral Research (2000) Diagnostic criteria for primary osteoporosis: 2000 edition. Osteoporosis Jpn. 18: 76–82 (in Japanease).
- [13]13. Khanine V, Fournier J-J, Requeda E, Luton J-P, Simon F, Crouzet J (2000) Osteoporotic fractures at presentation of Cushing's disease; two case reports and a literature review. Joint Bone Spine 67: 341–345.
- Authors
- OHMORI, N., NOMURA, K., OHMORI, K., KATO, Y., ITOH, T., & TAKANO, K.
- Affiliations
- Tokyo Women's Medical University (JP)
- ORCID
- KATO, YOSHIHARU
- Venue
- Endocrine Journal
- Publisher
- Japan Endocrine Society
- Published
- 2003
- Volume
- 50
- Issue
- 1
- Pages
- 1-7
- ISSN
- 0918-8959 (ISSN-L)
- 1348-4540
- OpenAlex
- W2010440256
- Cited by
- 81
- References
- 22
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 7 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 2 · 2019: 2 · 2018: 6 · 2017: 2 · 2016: 2 · 2015: 6 · 2014: 4 · 2012: 6
- FWCI
- 2.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Endocrine Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- Cushing's syndrome, osteoporosis, adrenal Cushing's syndrome, bone mineral density, atraumatic fractures, glucocorticoid-induced osteoporosis, dehydroepiandrosterone sulfate, urinary 17-ketosteroids, adrenal androgens, hypercortisolism, women
- MeSH terms
- Adrenocortical Hyperfunction, Adult, Cushing Syndrome, Female, Humans, Hyperpituitarism, Male, Middle Aged, Osteoporosis, Risk Factors, Bone Density, Prevalence, Logistic Models
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