Bone loss rate in adrenal incidentalomas: a longitudinal study.

Area of Science:

• Endocrinology
• Bone Metabolism
• Radiology

Background:

• Adrenal incidentalomas (AI) are common adrenal masses often associated with subclinical hypercortisolism (SH).
• SH may lead to clinical complications, including bone loss, but data on bone mineral density (BMD) in AI patients are conflicting.
• Understanding bone involvement in SH is crucial for managing AI.

Purpose of the Study:

• To investigate the longitudinal rate of spinal and femoral bone loss in female patients with AI.
• To determine if the degree of cortisol secretion (CS) influences the rate of bone loss.

Main Methods:

• A longitudinal study was conducted on 24 female patients with AI.
• Patients were divided into two groups based on urinary cortisol secretion (UFC) levels.
• Spinal BMD was measured using quantitative computed tomography and DXA; femoral BMD was measured by DXA.

Main Results:

• Patients with higher UFC levels (Group II) exhibited a significantly higher rate of spinal bone loss compared to those with lower UFC levels (Group I).
• The rate of spinal bone loss was significantly correlated with the degree of cortisol secretion across all patients.
• No significant difference was observed in femoral bone loss rates between the groups.

Conclusions:

• AI patients with higher cortisol secretion experience increased lumbar trabecular bone loss.
• The rate of spinal bone loss is directly related to the degree of cortisol secretion in AI patients.
• Lumbar spine BMD assessment is recommended for informed treatment decisions in female AI patients.