Bone Health in Patients With Adrenal Adenomas and Hypercortisolism: A Multicenter Cross-Sectional Study

Area of Science:

• Endocrinology
• Bone Metabolism
• Adrenal Disorders

Background:

• Bone health data in mild autonomous cortisol secretion (MACS) are limited.
• Hypercortisolism from adrenal adenomas can impact bone density.
• Understanding osteoporosis and fracture risk in these conditions is crucial.

Purpose of the Study:

• Assess osteoporosis and fragility fracture prevalence in patients with adrenal adenomas and hypercortisolism.
• Explore associations between cortisol excess and bone health outcomes.
• Investigate the role of frailty in these patient groups.

Main Methods:

• Multicenter, cross-sectional study with prospective enrollment (Jan 2019-Sep 2022).
• Included patients with nonfunctioning adrenal adenomas (NFA), MACS, Cushing syndrome (CS), and referents.
• Bone health questionnaires and dual-energy X-ray absorptiometry (DXA) assessments were performed.

Main Results:

• CS and MACS patients showed higher osteoporosis prevalence than referents.
• MACS patients with post-1mg-DST cortisol >83 nmol/L had increased osteoporosis risk.
• Only CS patients exhibited a higher prevalence of symptomatic fragility fractures.

Conclusions:

• Higher osteoporosis burden observed in CS and specific MACS subgroups.
• Symptomatic fragility fractures were primarily linked to CS.
• Cortisol excess levels correlate with osteoporosis but not necessarily fractures in MACS.