F Pugliese1, A S Salcuni1, C Battista1, V Carnevale2, G Guglielmi3, C Columbu4, F Velluzzi4, L Giovanelli5, C Eller-Vainicher6, A Scillitani7, I Chiodini5,8. 1. Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy. 2. Unit of Internal Medicine, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy. 3. Unit of Radiology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy. 4. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy. 5. Department of Endocrine and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, Milan, Italy. 6. Unit of Endocrinology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. 7. Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy. alfredo.scillitani@gmail.com. 8. Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
Abstract
PURPOSE: To evaluate the prevalence of less severe hypercortisolism (LSH) in fractured patients, and its association with hypertension, hyperglicemia, dyslipidemia, and obesity. METHOD: From July 2015 to October 2018 we enrolled all fractured patients admitted in our outpatient center for metabolic bone diseases, after exclusion of patients with secondary osteoporosis apart from diabetes and taking drugs known to affect bone metabolism. In all enrolled patients we collected data regarding gonadal status, history of diabetes, high blood pressure, dyslipidemia, and measured blood pressure, lipid profile, fasting glycaemia. Bone mass was measured with DXA at lumbar spine and femoral neck and the presence of fractures was evaluated with X-ray of thoracic and lumbar spine. All patients performed twice, 1 mg overnight dexametasone suppression test (DST) and, as confirmatory, 2day low-dose DST for diagnosing hypercortisolism. RESULTS: We enrolled 101 fractured patients (75 females, 26 males), aged 65 ± 10.3 years. Five out of 101 (5.0%) patients were diagnosed as LSH. Fifty-five (54.5%) out of 101 were hypertensive, 57 (56.4%) dyslipidemic, 17 (16.8%) hyperglicaemic, 28(27.7%) obese patients. LSH tended to be associated to blood hypertension [5/5 vs 50/96 (Fisher exact test, p = 0.06) hypertensive patients]. Four out five LSH patients were hypogonadic. CONCLUSIONS: Our study confirms that a nonnegligible percentage of fractured subjects actually presents an unrecognized hypercortisolism. Accordingly, regardless of age, we suggest to screen for hypercortisolism all patients with established osteoporosis and in particular hypertensive subjects.
PURPOSE: To evaluate the prevalence of less severe hypercortisolism (LSH) in fracturedpatients, and its association with hypertension, hyperglicemia, dyslipidemia, and obesity. METHOD: From July 2015 to October 2018 we enrolled all fracturedpatients admitted in our outpatient center for metabolic bone diseases, after exclusion of patients with secondary osteoporosis apart from diabetes and taking drugs known to affect bone metabolism. In all enrolled patients we collected data regarding gonadal status, history of diabetes, high blood pressure, dyslipidemia, and measured blood pressure, lipid profile, fasting glycaemia. Bone mass was measured with DXA at lumbar spine and femoral neck and the presence of fractures was evaluated with X-ray of thoracic and lumbar spine. All patients performed twice, 1 mg overnight dexametasone suppression test (DST) and, as confirmatory, 2day low-dose DST for diagnosing hypercortisolism. RESULTS: We enrolled 101 fracturedpatients (75 females, 26 males), aged 65 ± 10.3 years. Five out of 101 (5.0%) patients were diagnosed as LSH. Fifty-five (54.5%) out of 101 were hypertensive, 57 (56.4%) dyslipidemic, 17 (16.8%) hyperglicaemic, 28(27.7%) obesepatients. LSH tended to be associated to blood hypertension [5/5 vs 50/96 (Fisher exact test, p = 0.06) hypertensivepatients]. Four out five LSH patients were hypogonadic. CONCLUSIONS: Our study confirms that a nonnegligible percentage of fractured subjects actually presents an unrecognized hypercortisolism. Accordingly, regardless of age, we suggest to screen for hypercortisolism all patients with established osteoporosis and in particular hypertensive subjects.
Authors: I Chiodini; C Eller Vainicher; V Morelli; S Palmieri; E Cairoli; A S Salcuni; M Copetti; A Scillitani Journal: Eur J Endocrinol Date: 2016-07-13 Impact factor: 6.664