Trabecular bone score and bone mineral density as indices of skeletal fragility in endogenous Cushing's syndrome.
Cushing's syndrome
bone microarchitecture
bone mineral density
cortisol
trabecular bone score
Journal
Clinical endocrinology
ISSN: 1365-2265
Titre abrégé: Clin Endocrinol (Oxf)
Pays: England
ID NLM: 0346653
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
revised:
19
05
2023
received:
08
02
2023
accepted:
20
06
2023
medline:
3
8
2023
pubmed:
4
7
2023
entrez:
4
7
2023
Statut:
ppublish
Résumé
Endogenous Cushing's syndrome (CS) is a known cause of secondary osteoporosis. Vertebral fractures (VFs) in endogenous CS may occur despite normal bone mineral density (BMD). Trabecular bone score (TBS) is a relatively new, non-invasive technique to assess bone microarchitecture. The objective of our study was to analyse the BMD and bone microarchitecture using TBS in endogenous CS and compare it with a group of age and sex-matched healthy controls, and also analyse the factors predicting BMD and TBS. Cross-sectional study of cases and controls. We included 40 female patients with overt endogenous CS, out of which 32 were adrenocorticotropic hormone (ACTH)-dependent CS and 8 were ACTH-independent. We also included 40 healthy, female controls. Both patients and controls were subjected to an assessment of biochemical parameters and BMD and TBS. Patients with endogenous CS had significantly lower BMD at the lumbar spine, femoral neck, and total hip and significantly lower TBS than healthy controls (all p < .001), while no significant difference was noted in the distal radius BMD (p = .055). In endogenous CS, a large proportion of patients, n = 13 (32.5%) had normal BMD for age (BMD Z-score ≥ -2.0) with low TBS (L TBS should be considered an important complementary tool in addition to BMD for the routine assessment of skeletal health in CS.
Substances chimiques
Adrenocorticotropic Hormone
9002-60-2
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
253-261Informations de copyright
© 2023 John Wiley & Sons Ltd.
Références
Wengander S, Trimpou P, Papakokkinou E, Ragnarsson O. The incidence of endogenous Cushing's syndrome in the modern era. Clin Endocrinol. 2019;91(2):263-270.
Frara S, Allora A, di Filippo L, et al. Osteopathy in mild adrenal Cushing's syndrome and Cushing disease. Best Pract Res Clin Endocrinol Metab. 2021;35(2):101515.
Wang L, Heckmann BL, Yang X, Long H. Osteoblast autophagy in glucocorticoid-induced osteoporosis. J Cell Physiol. 2019;234(4):3207-3215.
Han L, Wang B, Wang R, Gong S, Chen G, Xu W. The shift in the balance between osteoblastogenesis and adipogenesis of mesenchymal stem cells mediated by glucocorticoid receptor. Stem Cell Res Ther. 2019;10(1):377.
Hu K, Adachi JD. Glucocorticoid induced osteoporosis. Expert Rev Endocrinol Metab. 2019;14(4):259-266.
Shi J, Wang L, Zhang H, et al. Glucocorticoids: dose-related effects on osteoclast formation and function via reactive oxygen species and autophagy. Bone. 2015;79:222-232.
Ross E. Cushing's syndrome-killing disease: discriminatory value of signs and symptoms aiding early diagnosis. Lancet. 1982;320:646-649.
Manelli F, Giustina A. Glucocorticoid-induced osteoporosis. Trends Endocrinol Metab. 2000;11:79-85.
Rahaman S, Jyotsna V, Kandasamy D, Shreenivas V, Gupta N, Tandon N. Bone health in patients with Cushing's Syndrome. Indian J Endocrinol Metab. 2018;22(6):766-769.
Apaydın T, Yavuz DG. Assessment of non-traumatic vertebral fractures in Cushing's syndrome patients. J Endocrinol Invest. 2021;44(8):1767-1773.
Armas LAG, Recker RR. Pathophysiology of osteoporosis. Endocrinol Metab Clin North Am. 2012;41(3):475-486.
Vidal B, Pinto A, Galvão MJ, et al. Bone histomorphometry revisited. Acta Reumatol Port. 2012;37(4):294-300.
Borelli A, Leite MOR, Correa PHS, et al. Bone histomorphometry in Cushing's syndrome. J Endocrinol Invest. 1992;15(11):783-787.
Guha I, Zhang X, Rajapakse CS, Chang G, Saha PK. Finite element analysis of trabecular bone microstructure using CT imaging and continuum mechanical modeling. Med Phys. 2022;49(6):3886-3899.
Shevroja E, Cafarelli FP, Guglielmi G, Hans D. DXA parameters, trabecular bone score (TBS) and bone mineral density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis. Endocrine. 2021;74(1):20-28.
Santos LM, Ohe MN, Pallone SG, et al. Trabecular bone score (TBS) in primary hyperparathyroidism (PHPT): a useful tool? J Clin Densitom. 2021;24(4):563-570.
Maamar El Asri M, Pariente Rodrigo E, Díaz-Salazar de la Flor S, et al. Trabecular bone score and 25-hydroxyvitamin D levels in microvascular complications of type 2 diabetes mellitus. Med Clin. 2022;158(7):308-314.
Calatayud M, Pérez-Olivares Martín L, Librizzi MS, et al. Trabecular bone score and bone mineral density in patients with long-term controlled acromegaly. Clin Endocrinol. 2021;95(1):58-64.
Ock SY, Chung YS, Choi YJ. Changes in bone mineral density and trabecular bone score in Graves' disease patients after anti-thyroid therapy. Osteoporos Sarcopenia. 2016;2(3):175-179.
Eller-Vainicher C, Morelli V, Ulivieri FM, et al. Bone quality, as measured by trabecular bone score in patients with adrenal incidentalomas with and without subclinical hypercortisolism. J Bone Miner Res. 2012;27(10):2223-2230.
Belaya ZE, Hans D, Rozhinskaya LY, et al. The risk factors for fractures and trabecular bone-score value in patients with endogenous Cushing's syndrome. Arch Osteoporos. 2015;10:44.
Vinolas H, Grouthier V, Mehsen-Cetre N, et al. Assessment of vertebral microarchitecture in overt and mild Cushing's syndrome using trabecular bone score. Clin Endocrinol. 2018;89(2):148-154.
Batista SL, de Araújo IM, Carvalho AL, et al. Beyond the metabolic syndrome: visceral and marrow adipose tissues impair bone quantity and quality in Cushing's disease. PLoS One. 2019;14(10):e0223432.
Kim BJ, Kwak MK, Ahn SH, Kim JS, Lee SH, Koh JM. The association of cortisol and adrenal androgen with trabecular bone score in patients with adrenal incidentaloma with and without autonomous cortisol secretion. Osteoporos Int. 2018;29(10):2299-2307.
Stachowska B, Halupczok-Żyła J, Kuliczkowska-Płaksej J, Syrycka J, Bolanowski M. Decreased trabecular bone score in patients with active endogenous Cushing's syndrome. Front Endocrinol. 2021;11:593173.
Nieman LK, Biller BMK, Findling JW, et al. The diagnosis of Cushing's syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008;93(5):1526-1540.
Binkley N, Bilezikian JP, Kendler DL, Leib ES, Lewiecki EM, Petak SM. Official positions of the international society for clinical densitometry and executive summary of the 2005 position development conference. J Clin Densitom. 2006;9(1):4-14.
Hans D, Goertzen AL, Krieg MA, Leslie WD. Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res. 2011;26(11):2762-2769.
McKiernan FE, Berg RL, Linneman JG. The utility of BMD Z-score diagnostic thresholds for secondary causes of osteoporosis. Osteoporos Int. 2011;22(4):1069-1077.
Shukla K, Sharma S, Gupta A, Raizada A, Vinayak K. Current scenario of prevalence of vitamin D deficiency in ostensibly healthy Indian population: a hospital based retrospective study. Indian J Clin Biochem. 2016;31(4):452-457.