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患有非功能性上腺瘤/轻度自主皮质醇分泌的绝经后妇女的骨健康状况与其基线早晨上皮质水平之间的关系
Alexandra-Ioana Trandafir1,2, Oana-Claudia Sima2, Nina Ionovici3
1PhD Doctoral School of "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Diagnostics (Basel, Switzerland)
|January 28, 2026
概括
在绝经后的女性中,低上腺皮质激素 (ACTH) 水平,具有非功能上腺瘤/轻度自主皮质醇分泌 (NFATs/MACS),可能表明骨损伤的风险较高. 抑制的ACTH可以作为评估这些患者骨健康的有用生物标志物.
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
- 上腺瘤 上腺瘤
背景情况:
- 葡萄糖皮质激素诱导的骨质疏松症是一种常见的二次骨质疏松症 (SOp),其主要原因是库辛综合征和皮质疗法.
- 上腺瘤,通常是非功能性上腺瘤 (NFATs),通常与SOp无关,但轻度自主皮质醇分泌 (MACS) 在30%-40%的病例中发生.
- 较低的上腺皮质激素水平 (ACTH) 可能表明与NFATs/MACS相关的并发症,尽管这不是正式的诊断标准.
研究的目的:
- 为了研究骨健康状况与绝经后妇女与NFATs/MACS的早晨ACTH水平的基线之间的关系.
- 在研究队列中使用DXA,FRAX和骨重塑标记物来评估骨健康.
主要方法:
- 在84名前不曾服用抗骨质疏松症药物的成年女性中进行了回顾性,现实生活,横向的研究.
- 参与者接受了CT和DXA扫描以及1毫克德甲抑制试验 (DST).
- 分析包括ACTH与骨健康指标,瘤特征和骨折风险评估的相关性.
主要成果:
- 骨质损伤 (骨质疏松症/骨质疏松症) 在65%的患者中存在;骨质疏松性骨折在4.76%中存在.
- 较低的ACTH (<10 pg/mL) 与更高的MACS率 (45.45%) 和更大的最大瘤直径 (LTD) (2.67厘米) 相关.
- 在低ACTH组中,ACTH与腰部BMD相关 (r=0.591,p=0.002);在低ACTH的MACS阴性受试者中观察到骨吸收升高 (CrossLaps).
结论:
- 一部分患有NFAT/MACS的患者可能容易受到骨损伤.
- 抑制的ACTH可以作为替代生物标志物来识别具有较高骨并发症风险的个体.
- 需要对ACTH切断值进行进一步的研究,以将ACTH测定纳入全面的骨状况评估中.
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