This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Torlontano, M. Articles by Scillitani, A. Search for Related Content PubMed PubMed Citation Articles by Torlontano, M. Articles by Scillitani, A. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Adrenal Gland Cancer Hazardous Substances DB HYDROCORTISONE

Altered Bone Mass and Turnover in Female Patients with Adrenal Incidentaloma: The Effect of Subclinical Hypercortisolism

Division and Research Unit of Endocrinology (M.T., I.C., V.T., A.S.), Departments of Clinical Laboratory (M.P.), Radiology (G.G., M.C.), Nuclear Medicine (S.M.), and Internal Medicine (V.C.), Scientific Institute Casa Sollievo della Sofferenza, 71013 S. Giovanni Rotondo (FG), Italy

Address all correspondence and requests for reprints to: Massimo Torlontano, M.D., Division and Research Unit of Endocrinology, Scientific Institute Casa Sollievo della Sofferenza, 71013 S. Giovanni Rotondo (FG), Italy.

The strategy of treatment for patients with adrenal incidentalomas (AI) may depend upon the presence of hormonal hypersecretion. Although alterations of bone turnover have been recently reported, data on bone mineral density (BMD) are not available in AI patients. We evaluated bone turnover and BMD in 32 female AI patients and 64 matched controls. Spinal and femoral BMD were similar in patients and controls. Serum bone GLA protein (6.8 ± 3.5 vs. 8.8 ± 3.2 ng/mL; P < 0.005) and PTH (48.8 ± 15.1 vs. 37.2 ± 10.9 pg/mL; P < 0.0001) were different in patients and controls. Patients were then subdivided into 2 groups: with (n = 8; group A) or without (n = 24; group B) subclinical hypercortisolism. PTH was higher (P < 0.05) in group A than in group B and in both groups than in controls (57.1 ± 13.6, 46.0 ± 14.8, and 37.2 ± 10.9 pg/mL, respectively), and bone GLA protein was lower in group A than in group B and controls (3.8 ± 2.3, 7.5 ± 3.1, and 8.8 ± 3.2 ng/mL, respectively; P < 0.05). Serum type I cross-linked C telopeptide and fasting urinary deoxypyridinoline/creatinine were not different in the three groups. BMD at each site was lower (P < 0.05) in group A than in group B and controls. Bone mass and metabolism are altered in AI patients with subclinical hypercortisolism and should be taken into account, therefore, when addressing the treatment of choice for these patients.

This article has been cited by other articles:

				I. Chiodini, V. Morelli, B. Masserini, A. S. Salcuni, C. Eller-Vainicher, R. Viti, F. Coletti, G. Guglielmi, C. Battista, V. Carnevale, et al. Bone Mineral Density, Prevalence of Vertebral Fractures, and Bone Quality in Patients with Adrenal Incidentalomas with and without Subclinical Hypercortisolism: An Italian Multicenter Study J. Clin. Endocrinol. Metab., September 1, 2009; 94(9): 3207 - 3214. [Abstract] [Full Text] [PDF]

				B. Masserini, V. Morelli, S. Bergamaschi, F. Ermetici, C. Eller-Vainicher, A. M. Barbieri, M. A. Maffini, A. Scillitani, B. Ambrosi, P. Beck-Peccoz, et al. The limited role of midnight salivary cortisol levels in the diagnosis of subclinical hypercortisolism in patients with adrenal incidentaloma Eur. J. Endocrinol., January 1, 2009; 160(1): 87 - 92. [Abstract] [Full Text] [PDF]

				P K Singh and H N Buch Adrenal incidentaloma: evaluation and management J. Clin. Pathol., November 1, 2008; 61(11): 1168 - 1173. [Abstract] [Full Text] [PDF]

				I. Chiodini, M. L. Mascia, S. Muscarella, C. Battista, S. Minisola, M. Arosio, S. A. Santini, G. Guglielmi, V. Carnevale, and A. Scillitani Subclinical Hypercortisolism among Outpatients Referred for Osteoporosis Ann Intern Med, October 16, 2007; 147(8): 541 - 548. [Abstract] [Full Text] [PDF]

				R Nawar and D Aron Adrenal incidentalomas -- a continuing management dilemma Endocr. Relat. Cancer, September 1, 2005; 12(3): 585 - 598. [Abstract] [Full Text] [PDF]

				I. Chiodini, G. Guglielmi, C. Battista, V. Carnevale, M. Torlontano, M. Cammisa, V. Trischitta, and A. Scillitani Spinal Volumetric Bone Mineral Density and Vertebral Fractures in Female Patients with Adrenal Incidentalomas: The Effects of Subclinical Hypercortisolism and Gonadal Status J. Clin. Endocrinol. Metab., May 1, 2004; 89(5): 2237 - 2241. [Abstract] [Full Text] [PDF]

				G. Mansmann, J. Lau, E. Balk, M. Rothberg, Y. Miyachi, and S. R. Bornstein The Clinically Inapparent Adrenal Mass: Update in Diagnosis and Management Endocr. Rev., April 1, 2004; 25(2): 309 - 340. [Abstract] [Full Text] [PDF]

				I. Chiodini, L. Tauchmanova, M. Torlontano, C. Battista, G. Guglielmi, M. Cammisa, A. Colao, V. Carnevale, R. Rossi, S. Di Lembo, et al. Bone Involvement in Eugonadal Male Patients with Adrenal Incidentaloma and Subclinical Hypercortisolism J. Clin. Endocrinol. Metab., December 1, 2002; 87(12): 5491 - 5494. [Abstract] [Full Text] [PDF]

				L. Tauchmanova, R. Rossi, B. Biondi, M. Pulcrano, V. Nuzzo, E.-A. Palmieri, S. Fazio, and G. Lombardi Patients with Subclinical Cushing's Syndrome due to Adrenal Adenoma Have Increased Cardiovascular Risk J. Clin. Endocrinol. Metab., November 1, 2002; 87(11): 4872 - 4878. [Abstract] [Full Text] [PDF]

				I. Chiodini, M. Torlontano, V. Carnevale, G. Guglielmi, M. Cammisa, V. Trischitta, and A. Scillitani Bone Loss Rate in Adrenal Incidentalomas: A Longitudinal Study J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5337 - 5341. [Abstract] [Full Text] [PDF]

				G. Osella, G. Reimondo, P. Peretti, A. Alì, P. Paccotti, A. Angeli, and M. Terzolo The Patients with Incidentally Discovered Adrenal Adenoma (Incidentaloma) Are Not at Increased Risk of Osteoporosis J. Clin. Endocrinol. Metab., February 1, 2001; 86(2): 604 - 607. [Abstract] [Full Text]

				M. Terzolo, S. Bossoni, A. Alí, M. Doga, G. Reimondo, G. Milani, P. Peretti, F. Manelli, A. Angeli, and A. Giustina Growth Hormone (GH) Responses to GH-Releasing Hormone Alone or Combined with Arginine in Patients with Adrenal Incidentaloma: Evidence for Enhanced Somatostatinergic Tone J. Clin. Endocrinol. Metab., March 1, 2000; 85(3): 1310 - 1315. [Abstract] [Full Text]