ArticleEndocrine2020
High bone marrow fat in patients with Cushing's syndrome and vertebral fractures.
Article in Endocrine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Evidence based Latin American Guidelines of clinical practice on prevention, diagnosis, management and treatment of glucocorticoid induced osteoporosis. A 2022 update : This manuscript has been produced under the auspices of the Committee of National Societies (CNS) and the Committee of Scientific Advisors (CSA) of the International Osteoporosis Foundation (IOF).Aging clinical and experimental research · 2022Pooled it
- Long-acting pasireotide improves clinical signs and quality of life in Cushing's disease: results from a phase III study.Journal of endocrinological investigation · 2020Trial
- Vertebral fractures may occur early in the history of Cushing disease associating with male gender and degree of cortisol secretion.Pituitary · 2026Article
- The local inactivation of glucocorticoid as regulator for the development of glucocorticoid-induced osteoporosis.PNAS nexus · 2025Article
- Cushing's disease and bone.Pituitary · 2024Review
- Bone quality in endocrine diseases: determinants and clinical relevance.Journal of endocrinological investigation · 2023Review
- Changes in serum cortisol levels after 10 days of overfeeding and fasting.American journal of physiology. Endocrinology and metabolism · 2023Article
- Article
- The Significance of Dual-Energy X-ray Absorptiometry (DXA) Examination in Cushing's Syndrome-A Systematic Review.Diagnostics (Basel, Switzerland) · 2023Review
- Disturbed bone marrow adiposity in patients with Cushing's syndrome and glucocorticoid- and postmenopausal- induced osteoporosis.Frontiers in endocrinology · 2023Article
- Skeletal disorders associated with the growth hormone-insulin-like growth factor 1 axis.Nature reviews. Endocrinology · 2022Review
- Benzofuran pyran hybrid prevents glucocorticoid induced osteoporosis in mice via modulation of canonical Wnt/β-catenin signaling.Apoptosis : an international journal on programmed cell death · 2022Article
- Update on vertebral fractures in pituitary diseases: from research to clinical practice.Hormones (Athens, Greece) · 2021Review
- Secondary hyperparathyroidism and thoracic vertebral fractures in heart failure middle-aged patients: a 3-year prospective study.Journal of endocrinological investigation · 2020Article
- MRI Assessment of Bone Marrow Composition in Osteoporosis.Current osteoporosis reports · 2020Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe evaluation of skeletal fragility in Cushing's syndrome (CS) is a clinical challenge, since dual-energy X-ray absorptiometry (DXA) does not capture abnormalities in bone microstructure induced by glucocorticoid excess. Hypercortisolism was shown to increase bone marrow adiposity, but it is still unknown whether high bone marrow fat (BMF) as measured by vertebral magnetic resonance spectroscopy may predict fracture risk in this clinical setting. In this cross-sectional study, we evaluated the association between BMF and vertebral fractures (VFs) in patients with CS.
methodsTwenty patients (5 M, age 44 ± 13 years) with active CS were evaluated for morphometric VFs, lumbar spine BMF, and bone mineral density (BMD). Fifteen healthy volunteers (4 M, age 43 ± 12 years) acted as control group for BMF evaluation.
resultsBMF was significantly higher in CS patients vs. controls (52.0% vs. 27.0%, p < 0.01), and was directly correlated with patients' age (p = 0.03), 24-hours urine-free cortisol (p = 0.03), midnight serum cortisol (p = 0.02), and serum CTX (p = 0.01). Patients with VFs (13 cases) showed significantly higher BMF vs. patients without VFs (65.0% vs. 24.0%, p = 0.03). Fractured patients with either normal BMD or osteopenia showed comparable BMF to fractured patients with either osteoporosis or low BMD for age (p = 0.71). When the analysis was restricted to patients with normal BMD or osteopenia, VFs were still significantly associated with higher BMF (p = 0.05).
conclusionsThis study provides a first evidence that vertebral adiposity may be a marker of hypercortisolism-induced skeletal fragility and measurement of spine BMF could have a role in the diagnostic work-up for the assessment of fracture risk in CS.
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