Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess
Objective. Osteoporosis and osteopenia (OS/OP) are frequent in patients with adrenal adenomas associated with cortisol excess (CE). However, the relationship between OS/OP and CE severity considering sex differences is unknown. Design. A cross-sectional observational study from January 2006 to Decem...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2022/5009395 |
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| author | Shoichiro Izawa Kazuhisa Matsumoto Kazuhiko Matsuzawa Takuyuki Katabami Takanobu Yoshimoto Michio Otsuki Masakatsu Sone Yoshiyu Takeda Shintaro Okamura Takamasa Ichijo Mika Tsuiki Tomoko Suzuki Mitsuhide Naruse Akiyo Tanabe |
| author_facet | Shoichiro Izawa Kazuhisa Matsumoto Kazuhiko Matsuzawa Takuyuki Katabami Takanobu Yoshimoto Michio Otsuki Masakatsu Sone Yoshiyu Takeda Shintaro Okamura Takamasa Ichijo Mika Tsuiki Tomoko Suzuki Mitsuhide Naruse Akiyo Tanabe |
| author_sort | Shoichiro Izawa |
| collection | DOAJ |
| description | Objective. Osteoporosis and osteopenia (OS/OP) are frequent in patients with adrenal adenomas associated with cortisol excess (CE). However, the relationship between OS/OP and CE severity considering sex differences is unknown. Design. A cross-sectional observational study from January 2006 to December 2015. Patients. 237 patients with adrenal adenoma associated with CE, including Cushing’s syndrome and mild autonomous cortisol secretion (MACS), diagnosed in 10 referral centers in Japan. MACS was defined by 1 mg overnight dexamethasone suppression test (DST) cortisol level >1.8 μg/dL. Measurements. Prevalence of fragility fractures, medication for osteoporosis, and bone mineral density. Results. In total, 112 of 237 patients, who were predominantly female (P<0.001) and had lower BMI (P=0.013), had OS/OP. Patients with OS/OP was significantly affected by CE (P<0.01) than those without. The adjusted odds ratio (OR) for predicting OS/OP was obtained in multivariate logistic regression analysis. Clinical measures of CE, 1 mg DST cortisol levels, were positively associated with OS/OP in total cases (OR 1.124, 95% CI: 1.070–1.181, P<0.001) and the cases with MACS (OR 1.156, 95%CI: 1.046–1.278, P=0.005). A cutoff value of 1 mg DST cortisol level >5.0 μg/dL was associated with OS/OP differently between men and women. OS/OP risk in men with MACS was significantly affected only by 1 mg DST cortisol levels. However, OS/OP risk in women with MACS was significantly affected by 1 mg DST cortisol levels and age. Conclusions. CE severity in adrenal adenoma is positively associated with OS/OP. However, the associated factors of OS/OP in the patients with MACS are different between men and women. |
| format | Article |
| id | doaj-art-604db6372abe4048a70ea52f8095da62 |
| institution | Kabale University |
| issn | 1687-8345 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-604db6372abe4048a70ea52f8095da622025-02-03T01:09:54ZengWileyInternational Journal of Endocrinology1687-83452022-01-01202210.1155/2022/5009395Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol ExcessShoichiro Izawa0Kazuhisa Matsumoto1Kazuhiko Matsuzawa2Takuyuki Katabami3Takanobu Yoshimoto4Michio Otsuki5Masakatsu Sone6Yoshiyu Takeda7Shintaro Okamura8Takamasa Ichijo9Mika Tsuiki10Tomoko Suzuki11Mitsuhide Naruse12Akiyo Tanabe13Division of Endocrinology and MetabolismDivision of Endocrinology and MetabolismDivision of Endocrinology and MetabolismDivision of Metabolism and EndocrinologyDepartment of Molecular Endocrinology and MetabolismDepartment of Metabolic MedicineDepartment of Diabetes, Endocrinology and NutritionDepartment of Internal MedicineDepartment of EndocrinologyDepartment of Diabetes and EndocrinologyDepartment of Endocrinology and MetabolismDepartment of Public HealthClinical Research Institute of Endocrinology and MetabolismDivision of EndocrinologyObjective. Osteoporosis and osteopenia (OS/OP) are frequent in patients with adrenal adenomas associated with cortisol excess (CE). However, the relationship between OS/OP and CE severity considering sex differences is unknown. Design. A cross-sectional observational study from January 2006 to December 2015. Patients. 237 patients with adrenal adenoma associated with CE, including Cushing’s syndrome and mild autonomous cortisol secretion (MACS), diagnosed in 10 referral centers in Japan. MACS was defined by 1 mg overnight dexamethasone suppression test (DST) cortisol level >1.8 μg/dL. Measurements. Prevalence of fragility fractures, medication for osteoporosis, and bone mineral density. Results. In total, 112 of 237 patients, who were predominantly female (P<0.001) and had lower BMI (P=0.013), had OS/OP. Patients with OS/OP was significantly affected by CE (P<0.01) than those without. The adjusted odds ratio (OR) for predicting OS/OP was obtained in multivariate logistic regression analysis. Clinical measures of CE, 1 mg DST cortisol levels, were positively associated with OS/OP in total cases (OR 1.124, 95% CI: 1.070–1.181, P<0.001) and the cases with MACS (OR 1.156, 95%CI: 1.046–1.278, P=0.005). A cutoff value of 1 mg DST cortisol level >5.0 μg/dL was associated with OS/OP differently between men and women. OS/OP risk in men with MACS was significantly affected only by 1 mg DST cortisol levels. However, OS/OP risk in women with MACS was significantly affected by 1 mg DST cortisol levels and age. Conclusions. CE severity in adrenal adenoma is positively associated with OS/OP. However, the associated factors of OS/OP in the patients with MACS are different between men and women.http://dx.doi.org/10.1155/2022/5009395 |
| spellingShingle | Shoichiro Izawa Kazuhisa Matsumoto Kazuhiko Matsuzawa Takuyuki Katabami Takanobu Yoshimoto Michio Otsuki Masakatsu Sone Yoshiyu Takeda Shintaro Okamura Takamasa Ichijo Mika Tsuiki Tomoko Suzuki Mitsuhide Naruse Akiyo Tanabe Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess International Journal of Endocrinology |
| title | Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess |
| title_full | Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess |
| title_fullStr | Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess |
| title_full_unstemmed | Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess |
| title_short | Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess |
| title_sort | sex difference in the association of osteoporosis and osteopenia prevalence in patients with adrenal adenoma and different degrees of cortisol excess |
| url | http://dx.doi.org/10.1155/2022/5009395 |
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