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The effects of cortisol and adrenal androgen on bone mass in Asians with and without subclinical hypercortisolism.
- Source :
-
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2019 May; Vol. 30 (5), pp. 1059-1069. Date of Electronic Publication: 2019 Feb 04. - Publication Year :
- 2019
-
Abstract
- Analyses using the largest Korean cohort of adrenal incidentaloma (AI) revealed that subtle cortisol excess in premenopausal women and reduced dehydroepiandrosterone-sulfate (DHEA-S) in postmenopausal women and men are associated with bone mineral density (BMD) reduction in Asian patients with subclinical hypercortisolism (SH).<br />Introduction: Few studies evaluated bone metabolism in Asians with SH. We investigated associations of cortisol and DHEA-S, an adrenal androgen, with BMD in Asians with AI, with or without SH.<br />Methods: We used cross-sectional data of a prospective multicenter study from Korea. We measured BMD, bone turnover markers, cortisol levels after 1-mg dexamethasone suppression test (1-mg DST), DHEA-S, and baseline cortisol to DHEA-S ratio (cort/DHEA-S) in 109 AI patients with SH (18 premenopausal, 38 postmenopausal women, and 53 men) and 686 with non-functional AI (NFAI; 59 premenopausal, 199 postmenopausal women, and 428 men).<br />Results: Pre- and postmenopausal women, but not men, with SH had lower BMDs at lumbar spine (LS) than those with NFAI (P = 0.008~0.016). Premenopausal women with SH also had lower BMDs at the hip than those with NFAI (P = 0.009~0.012). After adjusting for confounders, cortisol levels after 1-mg DST demonstrated inverse associations with BMDs at all skeletal sites only in premenopausal women (β = - 0.042~- 0.033, P = 0.019~0.040). DHEA-S had positive associations with LS BMD in postmenopausal women (β = 0.096, P = 0.001) and men (β = 0.029, P = 0.038). The cort/DHEA-S had inverse associations with LS BMD in postmenopausal women (β = - 0.081, P = 0.004) and men (β = - 0.029, P = 0.011). These inverse associations of cort/DHEA-S remained significant after adjusting for cortisol levels after 1-mg DST (β = - 0.079~- 0.026, P = 0.006~0.029). In postmenopausal women, the odds ratios of lower BMD by DHEA-S and cort/DHEA-S was 0.26 (95% CI, 0.08-0.82) and 3.40 (95% CI, 1.12-10.33), respectively.<br />Conclusion: Subtle cortisol excess in premenopausal women and reduced DHEA-S in postmenopausal women and men may contribute to BMD reduction in Asians with SH.
- Subjects :
- Adrenal Gland Neoplasms physiopathology
Adult
Aged
Biomarkers blood
Bone Remodeling physiology
Cross-Sectional Studies
Cushing Syndrome physiopathology
Female
Femur Neck physiopathology
Humans
Hydrocortisone physiology
Incidental Findings
Lumbar Vertebrae physiopathology
Male
Middle Aged
Osteoporosis blood
Osteoporosis physiopathology
Postmenopause blood
Postmenopause physiology
Premenopause blood
Premenopause physiology
Adrenal Gland Neoplasms blood
Bone Density physiology
Cushing Syndrome blood
Dehydroepiandrosterone Sulfate blood
Hydrocortisone blood
Subjects
Details
- Language :
- English
- ISSN :
- 1433-2965
- Volume :
- 30
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
- Publication Type :
- Academic Journal
- Accession number :
- 30719548
- Full Text :
- https://doi.org/10.1007/s00198-019-04871-5