ECE2021 Audio Eposter Presentations Pituitary and Neuroendocrinology (113 abstracts)
The association of z-score with early postoperative remission and characteristics of bone mineral density in patients with cushing’s disease: Single center study
emre gezer 1 , Zeynep Canturk 1 , Alev Selek 1 , Berrin Cetinarslan 1 , mehmet sözen 1 , Özlem Elen 2 , İhsan Anık 3 & Savaş Ceylan 3
1Kocaeli University Faculty of Medicine, Endocrinology and Metabolism, Kocaeli, Turkey; 2Kocaeli University Faculty of Medicine, Internal Medicine, Kocaeli, Turkey; 3Kocaeli University Faculty of Medicine, Neurosurgery, Kocaeli, Turkey
Introduction
Various direct and indirect mechanisms by which glucocorticoid (GC) excess and elevated adrenocorticotropic hormone (ACTH) levels impairs bone metabolism have been described. In the literature, there are different factors described which affect the early outcome of pituitary surgery in patients with CD including preoperative ACTH levels and the clinical severity of the disease. Combining these data, we conducted a retrospective study to investigate the association of BMD Z-scores with early postoperative remission rate and clinical parameters of the patients with CD.
Method
Patients diagnosed with CD were retrospectively evaluated. After the exclusion of 230 patients, a final cohort of 87 CD patients were included. Early postoperative remission was defined as a morning cortisol concentration measured on the first day after surgery of less than 5 µg/dL. The diagnosis of BMD ’below the expected range for age’ was defined as a Z-score ≤ -2.00 SD.
Results
No significant association was found between DXA results and early postoperative remission. There was also no significant difference in DXA results between eugonadal and menopausal groups. A significant negative correlation between preoperative morning cortisol level and BMD, T-score and Z-score of FT was shown, while there was a positive correlation between preoperative ACTH/Cortisol ratio and DXA results of L1-4 (Table 1).
| L1-4 | FN | FT | ||||||||
| BMD | T | Z | BMD | T | Z | BMD | T | Z | ||
| Cortisol | r | -0.115 | -0.122 | -0.177 | -0.119 | -0.104 | -0.159 | -0.219 | -0.237 | -0.276 |
| pa | 0.289 | 0.261 | 0.100 | 0.272 | 0.336 | 0.827 | 0.041 | 0.027 | 0.010 | |
| ACTH | r | 0.181 | 0.163 | 0.123 | 0.116 | 0.078 | 0.024 | 0.105 | 0.039 | -0.21 |
| pa | 0.094 | 0.130 | 0.255 | 0.285 | 0.473 | 0.827 | 0.335 | 0.720 | 0.845 | |
| ACTH/Cortisol | r | 0.280 | 0.258 | 0.257 | 0.199 | 0.156 | 0.126 | 0.249 | 0.206 | 0.160 |
| pa | 0.009 | 0.016 | 0.016 | 0.065 | 0.150 | 0.244 | 0.020 | 0.055 | 0.139 | |
| Size of the adenoma | r | 0.144 | 0.120 | 0.099 | 0.086 | 0.026 | -0.001 | 0.109 | 0.060 | 0.002 |
| pa | 0.182 | 0.270 | 0.361 | 0.430 | 0.808 | 0.993 | 0.316 | 0.584 | 0.983 | |
| ACTH: Adrenocorticotropic hormone, BMD: Bone mineral density, r: Correlation coefficient, FN: Femoral neck, FT: Total femur, L1-4: Lumbar vertebrae 1-4, T: T-score, Z: Z-score; aEvaluated by Spearman’s Rho correlation test | ||||||||||
Conclusions
To the best of our knowledge, this is the first study which investigates if the severity of bone loss is a predictive risk factor for the failure of transsphenoidal surgery for Cushing’s disease and there was no statistically significant relationship between these two entities.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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