Primary aldosteronism as a cause of secondary osteoporosis

Antonio Stefano Salcuni, Vincenzo Carnevale, Claudia Battista, Serena Palmieri, Cristina Eller-Vainicher, Vito Guarnieri, Flavia Pugliese, Giuseppe Guglielmi, Gaetano Desina, Salvatore Minisola, Iacopo Chiodini, Alfredo Scillitani

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE: Patients with primary aldosteronism (PA) have a high prevalence of osteoporosis (OP) and fractures (Fx). We evaluated the presence of PA in patients admitted to our metabolic bone disease outpatient clinic.

DESIGN: Study conducted on an in- and outpatient basis in a referral Italian endocrinology unit.

METHODS: A total of 2632 patients were evaluated. 2310 were excluded because they were taking drugs known to affect bone or mineralocorticoids metabolism or were diagnosed to have a secondary cause of osteoporosis. The remaining 322 subjects (304 females, 18 males) took part in the study. Bone mineral density (BMD) and thoracic and lumbar spine vertebral morphometry were performed by dual X-ray absorptiometry. All patients were screened for PA with aldosterone-to-renin ratio. In those who had positive results, confirmatory tests were performed.

RESULTS: Among 322 subjects, 213 were osteoporotics and 109 were not. PA was diagnosed in eleven out of 213 osteoporotic patients (5.2%) and one out of 109 non-osteoporotic subjects (0.9%, P = 0.066). PA was observed in the 26.1% of patients with the concomitant presence of osteoporosis, hypertension and hypercalciuria. Compared with patients without PA, patients with PA had mean values of urinary calcium excretion, 4.8 ± 2.5 mmol/day vs 7.6 ± 3.2 mmol/day, P < 0.001 and serum PTH levels, 5.4 pmol/L vs 7.3 pmol/L, P < 0.01, significantly higher.

CONCLUSIONS: PA should be considered among the causes of secondary OP.

Original languageEnglish
Pages (from-to)431-437
Number of pages7
JournalEuropean Journal of Endocrinology
Volume177
Issue number5
DOIs
Publication statusPublished - Nov 1 2017

Fingerprint

Hyperaldosteronism
Osteoporosis
Hypercalciuria
Mineralocorticoids
Metabolic Bone Diseases
Endocrinology
Photon Absorptiometry
Ambulatory Care Facilities
Aldosterone
Renin
Bone Density
Inpatients
Spine
Outpatients
Thorax
Referral and Consultation
Hypertension
Calcium
Bone and Bones
Serum

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Primary aldosteronism as a cause of secondary osteoporosis. / Salcuni, Antonio Stefano; Carnevale, Vincenzo; Battista, Claudia; Palmieri, Serena; Eller-Vainicher, Cristina; Guarnieri, Vito; Pugliese, Flavia; Guglielmi, Giuseppe; Desina, Gaetano; Minisola, Salvatore; Chiodini, Iacopo; Scillitani, Alfredo.

In: European Journal of Endocrinology, Vol. 177, No. 5, 01.11.2017, p. 431-437.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: Patients with primary aldosteronism (PA) have a high prevalence of osteoporosis (OP) and fractures (Fx). We evaluated the presence of PA in patients admitted to our metabolic bone disease outpatient clinic.DESIGN: Study conducted on an in- and outpatient basis in a referral Italian endocrinology unit.METHODS: A total of 2632 patients were evaluated. 2310 were excluded because they were taking drugs known to affect bone or mineralocorticoids metabolism or were diagnosed to have a secondary cause of osteoporosis. The remaining 322 subjects (304 females, 18 males) took part in the study. Bone mineral density (BMD) and thoracic and lumbar spine vertebral morphometry were performed by dual X-ray absorptiometry. All patients were screened for PA with aldosterone-to-renin ratio. In those who had positive results, confirmatory tests were performed.RESULTS: Among 322 subjects, 213 were osteoporotics and 109 were not. PA was diagnosed in eleven out of 213 osteoporotic patients (5.2{\%}) and one out of 109 non-osteoporotic subjects (0.9{\%}, P = 0.066). PA was observed in the 26.1{\%} of patients with the concomitant presence of osteoporosis, hypertension and hypercalciuria. Compared with patients without PA, patients with PA had mean values of urinary calcium excretion, 4.8 ± 2.5 mmol/day vs 7.6 ± 3.2 mmol/day, P < 0.001 and serum PTH levels, 5.4 pmol/L vs 7.3 pmol/L, P < 0.01, significantly higher.CONCLUSIONS: PA should be considered among the causes of secondary OP.",
author = "Salcuni, {Antonio Stefano} and Vincenzo Carnevale and Claudia Battista and Serena Palmieri and Cristina Eller-Vainicher and Vito Guarnieri and Flavia Pugliese and Giuseppe Guglielmi and Gaetano Desina and Salvatore Minisola and Iacopo Chiodini and Alfredo Scillitani",
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T1 - Primary aldosteronism as a cause of secondary osteoporosis

AU - Salcuni, Antonio Stefano

AU - Carnevale, Vincenzo

AU - Battista, Claudia

AU - Palmieri, Serena

AU - Eller-Vainicher, Cristina

AU - Guarnieri, Vito

AU - Pugliese, Flavia

AU - Guglielmi, Giuseppe

AU - Desina, Gaetano

AU - Minisola, Salvatore

AU - Chiodini, Iacopo

AU - Scillitani, Alfredo

PY - 2017/11/1

Y1 - 2017/11/1

N2 - OBJECTIVE: Patients with primary aldosteronism (PA) have a high prevalence of osteoporosis (OP) and fractures (Fx). We evaluated the presence of PA in patients admitted to our metabolic bone disease outpatient clinic.DESIGN: Study conducted on an in- and outpatient basis in a referral Italian endocrinology unit.METHODS: A total of 2632 patients were evaluated. 2310 were excluded because they were taking drugs known to affect bone or mineralocorticoids metabolism or were diagnosed to have a secondary cause of osteoporosis. The remaining 322 subjects (304 females, 18 males) took part in the study. Bone mineral density (BMD) and thoracic and lumbar spine vertebral morphometry were performed by dual X-ray absorptiometry. All patients were screened for PA with aldosterone-to-renin ratio. In those who had positive results, confirmatory tests were performed.RESULTS: Among 322 subjects, 213 were osteoporotics and 109 were not. PA was diagnosed in eleven out of 213 osteoporotic patients (5.2%) and one out of 109 non-osteoporotic subjects (0.9%, P = 0.066). PA was observed in the 26.1% of patients with the concomitant presence of osteoporosis, hypertension and hypercalciuria. Compared with patients without PA, patients with PA had mean values of urinary calcium excretion, 4.8 ± 2.5 mmol/day vs 7.6 ± 3.2 mmol/day, P < 0.001 and serum PTH levels, 5.4 pmol/L vs 7.3 pmol/L, P < 0.01, significantly higher.CONCLUSIONS: PA should be considered among the causes of secondary OP.

AB - OBJECTIVE: Patients with primary aldosteronism (PA) have a high prevalence of osteoporosis (OP) and fractures (Fx). We evaluated the presence of PA in patients admitted to our metabolic bone disease outpatient clinic.DESIGN: Study conducted on an in- and outpatient basis in a referral Italian endocrinology unit.METHODS: A total of 2632 patients were evaluated. 2310 were excluded because they were taking drugs known to affect bone or mineralocorticoids metabolism or were diagnosed to have a secondary cause of osteoporosis. The remaining 322 subjects (304 females, 18 males) took part in the study. Bone mineral density (BMD) and thoracic and lumbar spine vertebral morphometry were performed by dual X-ray absorptiometry. All patients were screened for PA with aldosterone-to-renin ratio. In those who had positive results, confirmatory tests were performed.RESULTS: Among 322 subjects, 213 were osteoporotics and 109 were not. PA was diagnosed in eleven out of 213 osteoporotic patients (5.2%) and one out of 109 non-osteoporotic subjects (0.9%, P = 0.066). PA was observed in the 26.1% of patients with the concomitant presence of osteoporosis, hypertension and hypercalciuria. Compared with patients without PA, patients with PA had mean values of urinary calcium excretion, 4.8 ± 2.5 mmol/day vs 7.6 ± 3.2 mmol/day, P < 0.001 and serum PTH levels, 5.4 pmol/L vs 7.3 pmol/L, P < 0.01, significantly higher.CONCLUSIONS: PA should be considered among the causes of secondary OP.

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U2 - 10.1530/EJE-17-0417

DO - 10.1530/EJE-17-0417

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JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

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