Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2006) 11 OC53

Unit of Endocrinology, San Giuseppe-Fatebenefratelli Hopital, AFaR, Milan, Italy.


Previous studies suggest that in patients with adrenal incidentalomas (AI) subclinical hypercortisolism (SH) exerts a deleterious effect on bone mineral density (BMD), but scarce data are available about vertebral fractures. We evaluate BMD and prevalence of vertebral fractures in a sample of AI subjects with and without SH.

Forty-seven consecutive AI inpatients were evaluated (17M, 30F). The patients were subdivided into two groups: with or without subclinical hypercortisolism (SH+/SH−). The diagnosis of SH was made on the presence of 2 of the following 3 alterations in the pituitary-adrenal axis: urinary free cortisol (UFC) levels higher than 70 mcg/24 hrs, serum cortisol levels after a 1-mg overnight dexamethasone suppression test (F after Dex) higher than 3.0 mcg/dL, and ACTH levels lower than 10 pg/mL. In all patients spinal and femoral BMD was measured by DXA and expressed as Z-score (LS Z-score, FN Z-score respectively). Results are shown in Table 1.

SH+ (n=14)SH− (n=33)
Age (Yrs)71.6±11.167.3±10
Gender (M/F)6/811/22
Diameter of adenoma (cm)2.04±0.882.46±0.42
BMI (Kg/m2)28.1±4.727.9±7.1
Prevalence of osteoporosis (%)2015
Z-score LS (g/cm2) −0.89±1.0920.184±0.894
Z-score FN (g/cm2)−0.20±0.6020.342±0.948
Vertebral Fractures: (%)88.9*16.7
Data are mean±S.D.; *P=0.001. In the logistic regression analysis, significant predictor of vertebral fracture was F-Dex (OR 0.024,CI 95% 0.002–0.315, P=0.005) but not age and BMI.

In patients with adrenal incidentalomas, SH is associated to a higher prevalence of vertebral fractures related to the degree of cortisol secretion. Bone involvement has to be evaluated in AI patients with SH.

Volume 11

8th European Congress of Endocrinology incorporating the British Endocrine Societies

European Society of Endocrinology 
British Endocrine Societies 

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