Dingfeng Li1, Ravinder Jeet Kaur1, Catherine D Zhang1, Andreas Ebbehoj2, Sumitabh Singh1, Elizabeth J Atkinson3, Sara J Achenbach3, Walter Rocca4,5,6, Sundeep Khosla1, Irina Bancos1. 1. Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA. 2. Departments of Clinical Medicine, Endocrinology and Diabetes, Aarhus University, Aarhus, Denmark. 3. Division of Biomedical Statistics and Informatics. 4. Division of Epidemiology, Department of Health Sciences Research. 5. Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. 6. Women's Health Research Center, Mayo Clinic, Rochester, Minnesota, USA.
Abstract
OBJECTIVE: Several small studies reported increased prevalence and incidence of asymptomatic vertebral fractures in patients with non-functioning adrenal adenomas and adenomas with mild autonomous cortisol secretion. However, the risk of symptomatic fractures at vertebrae, and at other sites remains unknown. Our objective was to determine the prevalence and incidence of symptomatic site-specific fractures in patients with adrenal adenomas. DESIGN: Population-based cohort study, Olmsted County, Minnesota, USA, 1995-2017. METHODS: Participants were the patients with adrenal adenoma and age/sex-matched referent subjects. Patients with overt hormone excess were excluded. Main outcomes measures were prevalence and incidence of bone fractures. RESULTS: Of 1004 patients with adrenal adenomas, 582 (58%) were women, and median age at diagnosis was 63 years (20-96). At the time of diagnosis, patients had a higher prevalence of previous fractures than referent subjects (any fracture: 47.9% vs 41.3%, P = 0.003, vertebral fracture: 6.4% vs 3.6%, P = 0.004, combined osteoporotic sites: 16.6% vs 13.3%, P = 0.04). Median duration of follow-up was 6.8 years (range: 0-21.9 years). After adjusting for age, sex, BMI, tobacco use, prior history of fracture, and common causes of secondary osteoporosis, patients with adenoma had hazard ratio of 1.27 (95% CI: 1.07-1.52) for developing a new fracture during follow up when compared to referent subjects. CONCLUSIONS: Patients with adrenal adenomas have higher prevalence of fractures at the time of diagnosis and increased risk to develop new fractures when compared to referent subjects.
OBJECTIVE: Several small studies reported increased prevalence and incidence of asymptomatic vertebral fractures in patients with non-functioning adrenal adenomas and adenomas with mild autonomous cortisol secretion. However, the risk of symptomatic fractures at vertebrae, and at other sites remains unknown. Our objective was to determine the prevalence and incidence of symptomatic site-specific fractures in patients with adrenal adenomas. DESIGN: Population-based cohort study, Olmsted County, Minnesota, USA, 1995-2017. METHODS: Participants were the patients with adrenal adenoma and age/sex-matched referent subjects. Patients with overt hormone excess were excluded. Main outcomes measures were prevalence and incidence of bone fractures. RESULTS: Of 1004 patients with adrenal adenomas, 582 (58%) were women, and median age at diagnosis was 63 years (20-96). At the time of diagnosis, patients had a higher prevalence of previous fractures than referent subjects (any fracture: 47.9% vs 41.3%, P = 0.003, vertebral fracture: 6.4% vs 3.6%, P = 0.004, combined osteoporotic sites: 16.6% vs 13.3%, P = 0.04). Median duration of follow-up was 6.8 years (range: 0-21.9 years). After adjusting for age, sex, BMI, tobacco use, prior history of fracture, and common causes of secondary osteoporosis, patients with adenoma had hazard ratio of 1.27 (95% CI: 1.07-1.52) for developing a new fracture during follow up when compared to referent subjects. CONCLUSIONS: Patients with adrenal adenomas have higher prevalence of fractures at the time of diagnosis and increased risk to develop new fractures when compared to referent subjects.
Authors: Jennifer L St Sauver; Brandon R Grossardt; Barbara P Yawn; L Joseph Melton; Joshua J Pankratz; Scott M Brue; Walter A Rocca Journal: Int J Epidemiol Date: 2012-11-18 Impact factor: 7.196
Authors: S Bovio; A Cataldi; G Reimondo; P Sperone; S Novello; A Berruti; P Borasio; C Fava; L Dogliotti; G V Scagliotti; A Angeli; M Terzolo Journal: J Endocrinol Invest Date: 2006-04 Impact factor: 4.256
Authors: Valentina Morelli; Cristina Eller-Vainicher; Antonio Stefano Salcuni; Francesca Coletti; Laura Iorio; Giovanna Muscogiuri; Silvia Della Casa; Maura Arosio; Bruno Ambrosi; Paolo Beck-Peccoz; Iacopo Chiodini Journal: J Bone Miner Res Date: 2011-08 Impact factor: 6.741