Bone quality, as measured by trabecular bone score in patients with adrenal incidentalomas with and without subclinical hypercortisolism

• DOI: 10.1002/jbmr.1648
• Publication Date: 2012-05-02T04:52:50Z
• Authors: Cristina Eller-Va...; Valentina Morelli; Fabio Massimo Uli...; Serena Palmieri; Volha V Zhukouskaya; Elisa Cairoli; Rosa Pino; Antonella Naccarato; Alfredo Scillitani; Paolo Beck-Peccoz; Iacopo Chiodini
• Keywords: Subclinical infection

Abstract Patients with adrenal incidentalomas (AIs) and subclinical hypercortisolism (SH) have increased risk of fracture independent bone mineral density (BMD) possibly due to reduced quality. The trabecular score (TBS) has been proposed as a index microarchitecture. aim the study was investigate TBS in AI. In 102 AI patients, SH diagnosed presence at least two following: (1) urinary free cortisol >70 µg/24 h (193.1 nmol/L); (2) after 1-mg dexamethasone suppression test (1-mg DST) >3.0 µg/dL (82.8 or (3) adrenocorticotropic hormone (ACTH) <10 pg/mL (<2.2 pmol/L). patients 70 matched controls, BMD measured lumbar spine (LS) femur (neck [FN] total [FT]) by dual X-ray absorptiometry assessed region LS-BMD; data were reported Z-scores. vertebral deformities radiograph. (n = 34) had lower LS-BMD (−0.31 ± 1.17), FT-BMD (−0.29 0.91), (−3.18 1.21) than without 68, 0.31 1.42, p 0.03; 0.19 0.97, 0.01; −1.70 1.54, < 0.0001, respectively) controls (0.42 1.52, 0.02; 0.14 0.76, −1.19 0.99, respectively). inversely correlated DST (β −0.26, t −2.79, 0.006) regardless age, LS-BMD, body mass (BMI), gender. associated low alone (odds ratio [OR], 4.8; 95% confidence interval [CI], 1.85–12.42, 0.001) cluster plus (OR, 4.37; CI, 1.71–11.4, 0.002), adjustment for BMI, Low showed good specificity (79%) predicting fractures, whereas normal (ie, > −1.5) high (88.1%) excluding fractures. Finally, predicted occurrence new 40 followed 24 months 11.2; 95%CI, 1.71–71.41, 0.012) age. SH, quality, TBS, is altered. useful detecting © 2012 American Society Bone Mineral Research.