Beom-Jun Kim1, Mi Kyung Kwak1, Seong Hee Ahn2, Hyeonmok Kim3, Seung Hun Lee1, Jung-Min Koh1. 1. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Department of Endocrinology, Inha University School of Medicine, Incheon, Korea. 3. Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
Abstract
Context: Despite the potential detrimental effects of aldosterone excess on bone metabolism, discrepancies exist between fracture risk and bone mass in patients with and without primary aldosteronism (PA). Objective: To clarify the possibility that aldosterone excess might mainly affect bone properties not explained by the bone mineral density (BMD). Design, Setting, and Patients: Among 625 consecutive patients with newly diagnosed adrenal incidentaloma (AI), 72 with biochemically confirmed PA and 335 with nonfunctional AI were defined as cases and controls, respectively. Results: In women, although no statistically significant differences in lumbar spine BMD were found between groups, the lumbar spine trabecular bone score (TBS) was significantly lower in patients with PA than in controls after adjustment for confounders (P = 0.007). Consistently, the plasma aldosterone concentration (PAC) correlated inversely with the lumbar spine TBS (P = 0.028) but not with bone mass in women. Compared with women in the lowest PAC quartile, those in the highest PAC quartile had significantly lower lumbar spine TBSs (P = 0.004). Importantly, all these observations in women remained statistically significant after additional adjustment for the lumbar spine BMD in the multivariable model. However, BMD and TBS at the lumbar spine did not differ according to the presence of PA and the level of PAC in men. Conclusion: These findings provide clinical evidence that aldosterone excess in PA might contribute to deteriorated bone quality through weak microarchitecture, regardless of bone mass, especially in women.
Context: Despite the potential detrimental effects of aldosterone excess on bone metabolism, discrepancies exist between fracture risk and bone mass in patients with and without primary aldosteronism (PA). Objective: To clarify the possibility that aldosterone excess might mainly affect bone properties not explained by the bone mineral density (BMD). Design, Setting, and Patients: Among 625 consecutive patients with newly diagnosed adrenal incidentaloma (AI), 72 with biochemically confirmed PA and 335 with nonfunctional AI were defined as cases and controls, respectively. Results: In women, although no statistically significant differences in lumbar spine BMD were found between groups, the lumbar spine trabecular bone score (TBS) was significantly lower in patients with PA than in controls after adjustment for confounders (P = 0.007). Consistently, the plasma aldosterone concentration (PAC) correlated inversely with the lumbar spine TBS (P = 0.028) but not with bone mass in women. Compared with women in the lowest PAC quartile, those in the highest PAC quartile had significantly lower lumbar spine TBSs (P = 0.004). Importantly, all these observations in women remained statistically significant after additional adjustment for the lumbar spine BMD in the multivariable model. However, BMD and TBS at the lumbar spine did not differ according to the presence of PA and the level of PAC in men. Conclusion: These findings provide clinical evidence that aldosterone excess in PA might contribute to deteriorated bone quality through weak microarchitecture, regardless of bone mass, especially in women.
Authors: Gian Paolo Rossi; Valeria Bisogni; Alessandra Violet Bacca; Anna Belfiore; Maurizio Cesari; Antonio Concistrè; Rita Del Pinto; Bruno Fabris; Francesco Fallo; Cristiano Fava; Claudio Ferri; Gilberta Giacchetti; Guido Grassi; Claudio Letizia; Mauro Maccario; Francesca Mallamaci; Giuseppe Maiolino; Dario Manfellotto; Pietro Minuz; Silvia Monticone; Alberto Morganti; Maria Lorenza Muiesan; Paolo Mulatero; Aurelio Negro; Gianfranco Parati; Martino F Pengo; Luigi Petramala; Francesca Pizzolo; Damiano Rizzoni; Giacomo Rossitto; Franco Veglio; Teresa Maria Seccia Journal: Int J Cardiol Hypertens Date: 2020-04-15
Authors: Seung Hun Lee; Jong Woo Kim; Hyun-Ki Yoon; Jung-Min Koh; Chan Soo Shin; Sang Wan Kim; Jung Hee Kim Journal: Endocrinol Metab (Seoul) Date: 2021-03-31
Authors: Christian Adolf; Leah T Braun; Carmina T Fuss; Stefanie Hahner; Heike Künzel; Laura Handgriff; Lisa Sturm; Daniel A Heinrich; Holger Schneider; Martin Bidlingmaier; Martin Reincke Journal: Endocrine Date: 2020-06-27 Impact factor: 3.633