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 Chiodini, I. Articles by Scillitani, A. Search for Related Content PubMed PubMed Citation Articles by Chiodini, I. Articles by Scillitani, A. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Adrenal Gland Cancer Hazardous Substances DB HYDROCORTISONE

Spinal Volumetric Bone Mineral Density and Vertebral Fractures in Female Patients with Adrenal Incidentalomas: The Effects of Subclinical Hypercortisolism and Gonadal Status

Units of Endocrinology (I.C., C.B., M.T., V.T., A.S.), Radiology (G.G., M.C.), and Internal Medicine (V.C.), Scientific Institute Casa Sollievo della Sofferenza, 71013 S. Giovanni Rotondo (FG), Italy; Unit of Endocrinology, San Giuseppe-Fatebenefratelli Hospital (I.C.), 20100 Milan, Italy; and Department of Clinical Sciences, Università La Sapienza (V.T.), 00100 Rome, Italy

Address all correspondence and requests for reprints to: Alfredo Scillitani, M.D., Unit of Endocrinology, Scientific Institute Casa Sollievo della Sofferenza, Viale dei Cappuccini, 71013 S. Giovanni Rotondo (FG), Italy. E-mail: endocrino{at}operapadrepio.it.

Although adrenal incidentalomas (AI) are not associated with clinically evident syndromes, some patients display biochemical features of subclinical hypercortisolism (SH). Previous studies indicated a negative effect of SH on bone in AI patients, but the prevalence of vertebral fractures and the roles of SH and gonadal status in volumetric bone mineral density are unknown. In 70 female AI patients and 84 controls, the prevalence of vertebral fractures and spinal bone mineral density (by quantitative computed tomography) were evaluated. Subjects were subdivided according to menopausal status into groups Pre (21 patients and 23 controls) and Post (49 patients and 61 controls); there were 14 and 35 patients without SH (SH^–) and 7 and 14 patients with SH (SH⁺) in groups Pre and Post, respectively. The prevalence of fractures was higher in SH⁺ than in controls and in SH^– subjects in both groups Pre [SH⁺, 42.9%; controls, 0% (P = 0.001); SH^–, 7.1% (P = 0.049)] and post [SH⁺, 78.6%; controls, 37.7% (P = 0.006); SH^– 42.9% (P = 0.024)]. In group Post, the mean z-score quantitative computed tomography values were lower in SH⁺ patients (–0.78 ± 0.29) than in controls (0.06 ± 0.14; P = 0.011) and SH^– patients (0.02 ± 0.19; P = 0.034). Evaluation of spinal bone is indicated in female AI patients with SH.

Abbreviations: BMD, Bone mineral density; CI, confidence interval; OR, odds ratio; QCT, quantitative computed tomography; ROI, region of interest; SH, subclinical hypercortisolism; UFC, urinary free cortisol.

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]

				L. Tauchmanova, R. Pivonello, M. C. De Martino, A. Rusciano, M. De Leo, C. Ruosi, C. Mainolfi, G. Lombardi, M. Salvatore, and A. Colao Effects of sex steroids on bone in women with subclinical or overt endogenous hypercortisolism Eur. J. Endocrinol., September 1, 2007; 157(3): 359 - 366. [Abstract] [Full Text] [PDF]

				S. H. Golden, S. Malhotra, G. S. Wand, F. L. Brancati, D. Ford, and K. Horton Adrenal Gland Volume and Dexamethasone-Suppressed Cortisol Correlate with Total Daily Salivary Cortisol in African-American Women J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1358 - 1363. [Abstract] [Full Text] [PDF]

				C. A. Rideout, W. Linden, and S. I. Barr High cognitive dietary restraint is associated with increased cortisol excretion in postmenopausal women. J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2006; 61(6): 628 - 633. [Abstract] [Full Text] [PDF]

				L. Tauchmanova, R. Pivonello, C. Di Somma, R. Rossi, M. C. De Martino, L. Camera, M. Klain, M. Salvatore, G. Lombardi, and A. Colao Bone Demineralization and Vertebral Fractures in Endogenous Cortisol Excess: Role of Disease Etiology and Gonadal Status J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1779 - 1784. [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]