#1706801 Impact of Adrenalectomy on Bone Density and Quality in Patients with Mild Autonomous Cortisol Secretion: A Prospective Longitudinal Cohort Study

• DOI: 10.1016/j.eprac.2024.03.147
• Publication Date: 2024-05-08T00:22:24Z
• Authors: Jasmine Saini; Jasmine Saini; Vanessa Fell; Beth Atkinson; Sara Achenbach; Irina Bancos

Patients with mild autonomous cortisol secretion (MACS) have a high risk of fractures, discordant to the degree bone mineral density (BMD) loss. Increased fractures may be due impaired quality. Previous cross-sectional studies demonstrated that trabecular score (TBS), DXA-based measurement correlates parameters microstructure, was lower in MACS vs referent subjects. The impact adrenalectomy on TBS has not been characterized patients MACS. Thus, we aimed determine and BMD. In this single-center prospective cohort study, adults scheduled for subjects were enrolled between 2018 2023. defined as >1.8 mcg/dL after 1 mg dexamethasone suppression test without features overt hypercortisolism. Referent included if they had no adrenal disorders. Participants underwent scan at baseline follow-up evaluation least 10 months later. Differences assessed (1) femur neck BMD (2) total (3) forearm radius 1/3 (4) spine L1-L4 (5) TBS. We evaluated 41 before adrenalectomy, 31 visit, similar interval (median 1.6, IQR 1.2-2.0 1.5, 1.0-2.2 years, P=0.759). Both groups sex distributions (women, 66% 84%, P=0.086), however, older than group age 57.3, 48.8-66.9 49.0, 41.7-57.9 P=0.005). After change (mean -0.009 g/cm, SD: 0.04, P=0.198), -0.013, P= 0.078), or -0.016 SD=0.06, P=0.09). Radius deteriorated both -0.034, SD=0.045, P< 0.001) -0.018, P=0.002). improved by mean 0.037 SD 0.085, P=0.032, while did -0.004, SD=0.051, P=0.539). Adrenalectomy leads improvement quality, but