在非功能性上腺附带瘤患者中,脆弱性骨折和皮质醇分泌
Vittoria Favero1, Elisa Cairoli2, Cristina Eller-Vainicher3
1Department of Medical Biotechnology and Translational Medicine, University of Milan, 20100 Milan, Italy.
Journal of the Endocrine Society
|August 29, 2024
概括
患有非功能性上腺意外瘤 (NFAI) 和血清皮质醇升高 (≥1.2μg/dL) 的患者有脊椎骨折 (VFx) 风险增加. 这种荷尔蒙标志物可能会识别出需要密切监测VFx的个体.
科学领域:
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
- 放射学 放射学是一门学科.
背景情况:
- 非功能性上腺瘤 (NFAI) 的骨影响在很大程度上仍然未被描述.
- 脊椎骨折 (VFx) 是一个严重的健康问题,识别风险人群至关重要.
研究的目的:
- 确定NFAI患者中VFx的患病率和发病率.
- 为了确定一种荷尔蒙标记物,特别是血清皮质醇在1mg-德克萨米他测试 (F-1mgDST) 后,与NFAI患者的VFx风险相关.
主要方法:
- 一项涉及横截面和纵向臂的回顾性研究.
- 评估了306名NFAI患者和213名对照人群的VFx患病率,以及85名NFAI患者的VFx发病率,平均随访时间为30.3个月.
- 评估F-1mgDST,腰椎 (LS) 和大腿部 (FN) 的骨矿物质密度 (BMD),以及通过脊柱放射的VFx.
主要成果:
- 与对照组 (10.8%) 和较低F-1mgDST (12.6%) 的NFAI患者相比,F-1mgDST≥1.2μg/dL的NFAI患者表现出明显更高的VFx流行率 (29.5%).
- 纵向手臂显示,高F-1mgDST (≥1.2μg/dL) 组的VFx发病率 (19.3%) 在较高的F-1mgDST (≥1.2μg/dL) 组中比较高 (3.6%).
- 值得注意的是,高F-1mgDST组的所有VFx事件都发生在没有低BMD的患者中,这表明F-1mgDST是独立于骨密度的潜在预测因素.
结论:
- 在NFAI患者中,F-1mgDST水平升高 (≥1.2μg/dL) 与常见的脊椎骨折显著相关.
- 这种荷尔蒙标记可能有助于识别NFAI患者患有发生脊椎骨折的风险增加,这需要进一步调查和潜在的临床应用.
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