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

Cristina Eller-Vainicher, Valentina Morelli, Fabio Massimo Ulivieri, Serena Palmieri, Volha V. Zhukouskaya, Elisa Cairoli, Rosa Pino, Antonella Naccarato, Alfredo Scillitani, Paolo Beck-Peccoz, Iacopo Chiodini

Research output: Contribution to journalArticle

Abstract

Patients with adrenal incidentalomas (AIs) and subclinical hypercortisolism (SH) have increased risk of fracture independent of bone mineral density (BMD) and possibly due to reduced bone quality. The trabecular bone score (TBS) has been proposed as a index of bone microarchitecture. The aim of the study was to investigate TBS in AI. In 102 AI patients, SH was diagnosed in the presence of at least two of the following: (1) urinary free cortisol >70 μg/24 h (193.1 nmol/L); (2) cortisol after 1-mg dexamethasone suppression test (1-mg DST) >3.0 μg/dL (82.8 nmol/L); or (3) adrenocorticotropic hormone (ACTH) -1.5) plus normal LS-BMD high specificity (88.1%) for excluding fractures. Finally, TBS predicted the occurrence of a new fracture in 40 patients followed for 24 months (OR, 11.2; 95%CI, 1.71-71.41, p = 0.012) regardless of LS-BMD, BMI, and age. In SH, bone quality, as measured by TBS, is altered. TBS is useful in detecting AI patients at risk of fractures.

Original languageEnglish
Pages (from-to)2223-2230
Number of pages8
JournalJournal of Bone and Mineral Research
Volume27
Issue number10
DOIs
Publication statusPublished - Oct 2012

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Keywords

  • SUBCLINICAL HYPERCORTISOLISM
  • TRABECULAR BONE SCORE
  • VERTEBRAL FRACTURES

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism

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