Observational studyOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018
The association of cortisol and adrenal androgen with trabecular bone score in patients with adrenal incidentaloma with and without autonomous cortisol secretion.
Observational study in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 27 citations in OpenAlex.
- Musculoskeletal Assessment in Patients with Adrenal Incidentalomas: Should We Integrate the Trabecular Bone Score and/or Circulating Irisin?Diagnostics (Basel, Switzerland) · 2026Article
- The Relationship Between Bone Health Status of Post-Menopausal Women with Non-Functional Adrenal Tumours/Mild Autonomous Cortisol Secretion and Their Baseline Morning Adrenocorticotropic Level.Diagnostics (Basel, Switzerland) · 2026Article
- Mild autonomous cortisol secretion: impact on bone health and quality of life. A review.Endocrine · 2025Review
- Relationship Among Fragility Fractures and the Overall Cardiovascular Burden in Endogenous Cushing Syndrome.Journal of the Endocrine Society · 2025Article
- Mild autonomous cortisol secretion: pathophysiology, comorbidities and management approaches.Nature reviews. Endocrinology · 2024Review
- Adrenal steroid metabolites and bone status in patients with adrenal incidentalomas and hypercortisolism.EBioMedicine · 2023Article
- Management of Adrenal Cortical Adenomas: Assessment of Bone Status in Patients with (Non-Functioning) Adrenal Incidentalomas.Journal of clinical medicine · 2023Review
- Systematic evaluation for the causal effects of blood metabolites on osteoporosis: Genetic risk score and Mendelian randomization.Frontiers in public health · 2022Article
- Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess.International journal of endocrinology · 2022Article
- Application of the Trabecular Bone Score in Clinical Practice.Journal of bone metabolism · 2021Article
- The effects of cortisol and adrenal androgen on bone mass in Asians with and without subclinical hypercortisolism.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Article
- Glucocorticoids and Trabecular Bone Score.Journal of medicine and lifeReview
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
Despite ethnic differences in cortisol sensitivity, only one study in Caucasians has assessed trabecular bone score (TBS) in patients with subclinical hypercortisolism (SH). We showed that both subtle cortisol excess and reduced adrenal androgen may contribute to impaired bone quality in Asian women with SH.
introductionOne study in Caucasians has assessed trabecular bone score (TBS), an index of bone microstructure, in adrenal incidentaloma (AI) patients with subclinical hypercortisolism (SH). There are ethnic differences in cortisol sensitivities between Caucasian and Asian populations. We investigated the associations of cortisol and the adrenal androgen dehydroepiandrosterone-sulfate (DHEA-S) with TBS in AI patients with SH, adrenal Cushing's syndrome (CS), and nonfunctional AI (NFAI).
methodsWe measured TBS, cortisol levels after the overnight 1 mg dexamethasone suppression test (1 mg DST), and cortisol/DHEA-S in 61 patients with SH (30 men; 31 women), 19 with adrenal CS (4 men; 15 women), and 355 with NFAI (213 men; 142 women).
resultsAfter adjusting for confounders, the serum cortisol level after 1 mg DST was inversely correlated with TBS in men (β = -0.133, P = 0.045) and women (β = - 0.140, P = 0.048). Higher cortisol/DHEA-S ratio was associated with lower TBS in women (β = - 0.252, P < 0.001), but not men. This inverse association of cortisol/DHEA-S ratio in women remained statistically significant after adjusting for the serum cortisol level after 1 mg DST (β = - 0.221, P = 0.008). Compared with women with NFAI, women with SH had 2.2% lower TBS (P = 0.040). Deteriorated bone microstructure (TBS < 1.230) was associated with the serum cortisol level after 1 mg DST (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.04-4.53) and cortisol/DHEA-S ratio (OR, 2.05; 95% CI, 1.03-4.08).
conclusionsSubtle cortisol excess in both genders and reduced DHEA-S, especially in women, may contribute to impaired bone quality in Asian patients with SH.
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