BACKGROUND: Hypercortisolism is known to cause osteoporosis. OBJECTIVE: To evaluate the prevalence of subclinical hypercortisolism in participants referred for evaluation of osteoporosis. DESIGN: Cross-sectional study. SETTING: Two community hospitals and research institutes in Italy. PATIENTS: 219 patients without clinically overt hypercortisolism or other secondary causes of osteoporosis who were referred for evaluation of osteoporosis between January 2005 and December 2005. MEASUREMENTS: Bone mineral density was measured by using dual-energy x-ray absorptiometry, and hypercortisolism was assessed with serum cortisol levels after a dexamethasone suppression test. Also measured were 24-hour urinary free cortisol levels and midnight plasma cortisol levels. RESULTS: Seven of 65 patients with T-scores of 2.5 or less and vertebral fractures had subclinical hypercortisolism (prevalence, 10.8% [95% CI, 3.23% to 18.31%]). This prevalence was 4.8% (CI, 1.32% to 8.20%) among patients with osteoporosis. In multivariable analyses adjusted for age, sex, and body mass index, a positive dexamethasone suppression test result was associated with the presence of osteoporosis (odds ratio, 3.37 [CI, 1.78 to 6.43]; P < 0.001) and vertebral fractures (odds ratio, 1.70 [CI, 1.04 to 2.79]; P = 0.035). LIMITATIONS: The study was conducted in a referral setting; its findings may not apply to the general population. CONCLUSIONS: Subclinical hypercortisolism may be more common than is generally recognized in patients with osteoporosis in whom secondary causes of osteoporosis have been excluded.
BACKGROUND:Hypercortisolism is known to cause osteoporosis. OBJECTIVE: To evaluate the prevalence of subclinical hypercortisolism in participants referred for evaluation of osteoporosis. DESIGN: Cross-sectional study. SETTING: Two community hospitals and research institutes in Italy. PATIENTS: 219 patients without clinically overt hypercortisolism or other secondary causes of osteoporosis who were referred for evaluation of osteoporosis between January 2005 and December 2005. MEASUREMENTS: Bone mineral density was measured by using dual-energy x-ray absorptiometry, and hypercortisolism was assessed with serum cortisol levels after a dexamethasone suppression test. Also measured were 24-hour urinary free cortisol levels and midnight plasma cortisol levels. RESULTS: Seven of 65 patients with T-scores of 2.5 or less and vertebral fractures had subclinical hypercortisolism (prevalence, 10.8% [95% CI, 3.23% to 18.31%]). This prevalence was 4.8% (CI, 1.32% to 8.20%) among patients with osteoporosis. In multivariable analyses adjusted for age, sex, and body mass index, a positive dexamethasone suppression test result was associated with the presence of osteoporosis (odds ratio, 3.37 [CI, 1.78 to 6.43]; P < 0.001) and vertebral fractures (odds ratio, 1.70 [CI, 1.04 to 2.79]; P = 0.035). LIMITATIONS: The study was conducted in a referral setting; its findings may not apply to the general population. CONCLUSIONS: Subclinical hypercortisolism may be more common than is generally recognized in patients with osteoporosis in whom secondary causes of osteoporosis have been excluded.
Authors: Zhanna E Belaya; Alexander V Iljin; Galina A Melnichenko; Liudmila Y Rozhinskaya; Natalia V Dragunova; Larisa K Dzeranova; Svetlana A Butrova; Ekaterina A Troshina; Ivan I Dedov Journal: Endocrine Date: 2012-03-25 Impact factor: 3.633
Authors: Lynnette K Nieman; Beverly M K Biller; James W Findling; John Newell-Price; Martin O Savage; Paul M Stewart; Victor M Montori Journal: J Clin Endocrinol Metab Date: 2008-03-11 Impact factor: 5.958
Authors: F Pugliese; A S Salcuni; C Battista; V Carnevale; G Guglielmi; C Columbu; F Velluzzi; L Giovanelli; C Eller-Vainicher; A Scillitani; I Chiodini Journal: Endocrine Date: 2021-01-23 Impact factor: 3.633
Authors: Zhanna E Belaya; Alexander V Iljin; Galina A Melnichenko; Alexander G Solodovnikov; Liudmila Y Rozhinskaya; Larisa K Dzeranova; Ivan I Dedov Journal: Bonekey Rep Date: 2016-06-15