Bone mineral density, prevalence of vertebral fractures, and bone quality in patients with adrenal incidentalomas with and without subclinical hypercortisolism: An Italian multicenter study

Iacopo Chiodini, Valentina Morelli, Benedetta Masserini, Antonio Stefano Salcuni, Cristina Eller-Vainicher, Raffaella Viti, Francesca Coletti, Giuseppe Guglielmi, Claudia Battista, Vincenzo Carnevale, Laura Iorio, Paolo Beck-Peccoz, Maura Arosio, Bruno Ambrosi, Alfredo Scillitani

Research output: Contribution to journalArticle


Context: In patients with adrenal incidentalomas and subclinical hypercortisolism (SH), the factors influencing bone and the prevalence of vertebral fractures are debated. Spinal deformity index (SDI), which reflects bone quality, has never been evaluated. Objective: The objective of the study was to investigate in these patients SDI and factors influencing the prevalence of fractures. Design: This was a retrospective, multicenter study. Setting: The study was conducted on an in- and outpatient basis. Patients: Patients included 287 adrenal incidentaloma patients (111 eugonadal males, 31 premenopausal, 145 postmenopausal females) and 194 controls (90 eugonadal males, 29 premenopausal, 75 postmenopausal females). Main Outcome Measure: Bone mineral density (BMD) was measured by dual X-ray absorptiometry at lumbar spine and femoral neck. By radiograph each vertebra was assessed as intact (grade 0) or grade 1 (20-25%), 2 (25-40%), or 3 (>40%) deformity; SDI was calculated by summing the grade of deformity for each vertebra. SH was diagnosed in the presence of at least two of the following: urinary free cortisol greater than 70 μg per 24 h (193.1 nmol/liter), cortisol after 1-mg dexamethasone test greater than 3.0 μg/dl (>82.8 nmol/liter), ACTH less than 10 pg/ml (

Original languageEnglish
Pages (from-to)3207-3214
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Issue number9
Publication statusPublished - Sep 2009


ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

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