ArticleJournal of endocrinological investigation2014
Fracture risk assessment before and after resolution of endogenous hypercortisolism: is the FRAX® algorithm useful?
Article in Journal of endocrinological investigation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 10 citations in OpenAlex.
- Screening for endogenous hypercortisolism in patients with osteoporosis and fractures: why, when and how.Journal of endocrinological investigation · 2025Review
- Review
- Article
- Decreased Trabecular Bone Score in Patients With Active Endogenous Cushing's Syndrome.Frontiers in endocrinology · 2020Article
- Article
- Observational
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7 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeFracture risk data following curative treatment of Cushing's syndrome (CS) are scarce and the role of bisphosphonates in bone recovery after remission is controversial. We evaluated the effects of hypercortisolism remission in bone recovery in CS. Then, we assessed if the FRAX(®) algorithm calculated before the cure can predict fracture risk after cure.
methodsThirty-six patients with CS were retrospectively investigated. Bone turnover markers, bone mineral density (BMD) at the lumbar spine (L1-L4) and left femur (both neck and total hip were considered), and fracture risk using FRAX(®) algorithm with femoral neck BMD were evaluated at diagnosis and after a median follow-up of 24 months (range 12-108 months) from hypercortisolism remission. Data about bone active therapy were analyzed.
resultsHypercortisolism remission was associated with the improvement of all densitometric parameters and with the reduction of fracture risk. The percentage change in BMD and the fracture risk were not significantly different in bisphosphonate-treated vs. untreated patients. During follow-up, three fractured patients at baseline exhibited a new vertebral fracture. A baseline 10-year probability of major osteoporotic fractures (FRAX(®) Major) of 17 % was able to predict the occurrence of a new vertebral fracture during follow-up after cure with 100 % sensitivity, 77 % specificity, 81 % positive predictive value and 100 % negative predictive value.
conclusionsOsteoporosis and fracture risk may be reversible after curative treatment of CS, regardless of bisphosphonate therapy. We suggest applying the FRAX(®) algorithm to all active CS patients using a baseline FRAX(®) Major of 17 % as "intervention threshold".
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