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- Title
Bone Evaluation by High-Resolution Peripheral Quantitative Computed Tomography in Patients With Adrenal Incidentaloma.
- Authors
Barbosa Moraes, Aline; Pessoa de Paula, Marcela; de Paula Paranhos-Neto, Francisco; Ribeiro Cavalari, Emanuela Mello; Cordeiro de Morais, Felipe Fernandes; Carvalho Curi, Daniel Silva; Cardoso Lima, Luis Felipe; Carvalho de Mendonça, Laura Maria; Fleiuss Farias, Maria Lucia; Madeira, Miguel; Vieira Neto, Leonardo; Moraes, Aline Barbosa; de Paula, Marcela Pessoa; Cavalari, Emanuela Mello Ribeiro; de Morais, Felipe Fernandes Cordeiro; Curi, Daniel Silva Carvalho; Lima, Luis Felipe Cardoso; de Mendonça, Laura Maria Carvalho; Farias, Maria Lucia Fleiuss
- Abstract
<bold>Context: </bold>Data regarding high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with adrenal incidentaloma (AI) are unknown.<bold>Purpose: </bold>To evaluate the areal bone mineral density (aBMD), microstructure, and fractures in patients with nonfunctioning AI (NFAI) and autonomous cortisol secretion (ACS).<bold>Methods: </bold>We evaluated 45 patients with NFAI (1 mg dexamethasone suppression test [DST] ≤1.8 µg/dL) and 30 patients with ACS (1 mg DST 1.9-5.0 µg/dL). aBMD was measured using dual-energy X-ray absorptiometry; vertebral fracture by spine X-ray; and bone geometry, volumetric bone mineral density (vBMD), and microstructure by HR-pQCT.<bold>Results: </bold>Patients with ACS showed lower aBMD values at the spine, femoral neck, and radius 33% than those with NFAI. Osteoporosis was frequent in both groups: NFAI (64.9%) and ACS (75%). Parameters at the distal radius by HR-pQCT were decreased in patients with ACS compared to those with NFAI: trabecular vBMD (Tb.vBMD, P = 0.03), inner zone of the trabecular region (Inn.Tb.vBMD, P = 0.01), the bone volume/tissue volume ratio (BV/TV, P = 0.03) and trabecular thickness (P = 0.04). As consequence, a higher ratio of the outer zone of the trabecular region/inner zone vBMD (Meta/Inn.vBMD, P = 0.003) was observed. A correlation between the cortisol levels after 1 mg DST and Meta/Inn.vBMD ratio was found (r = 0.29; P = 0.01). The fracture frequency was 73.7% in patients with ACS vs 55.6% in patients with NFAI (P = 0.24).<bold>Conclusion: </bold>Our findings point to an association between trabecular bone microarchitectural derangement at the distal radius and ACS. Our data suggest that AI have a negative impact on bone when assessed by HR-pQCT, probably associated to subclinical hypercortisolism.
- Subjects
BONE density; BONES; COMPUTED tomography; CUSHING'S syndrome diagnosis; DIGITAL image processing; SPONTANEOUS fractures; ADRENAL cortex; CUSHING'S syndrome; PHOTON absorptiometry; CROSS-sectional method; ADRENAL tumors; VERTEBRAL fractures; HYDROCORTISONE; DISEASE complications
- Publication
Journal of Clinical Endocrinology & Metabolism, 2020, Vol 105, Issue 8, p1
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgaa263