Prevalence of less severe hypercortisolism in fractured patients admitted in an outpatient clinic for metabolic bone diseases

Prevalence of less severe hypercortisolism in fractured patients admitted in an outpatient clinic for metabolic bone diseases

Purpose To evaluate the prevalence of less severe hypercortisolism (LSH) in fractured patients, and its association with hypertension, hyperglicemia, dyslipidemia, and obesity. Method From July 2015 to October 2018 we enrolled all fractured patients admitted in our outpatient center for metabolic bo...

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Bibliographic Details
Published in:Endocrine Vol. 73; no. 1; pp. 203 - 208
Main Authors: Pugliese, F., Salcuni, A. S., Battista, C., Carnevale, V., Guglielmi, G., Columbu, C., Velluzzi, F., Giovanelli, L., Eller-Vainicher, C., Scillitani, A., Chiodini, I.
Format: Journal Article
Language:English
Published: New York Springer US 01-07-2021
Springer Nature B.V
Subjects:
Blood glucose
Blood pressure
Bone diseases
Bone mass
Bone turnover
Diabetes
Diabetes mellitus
Dosage
Dual energy X-ray absorptiometry
Dyslipidemia
Endocrinology
Fractures
Humanities and Social Sciences
Hypertension
Internal Medicine
Medicine
Medicine & Public Health
Metabolism
multidisciplinary
Obesity
Original Article
Osteoporosis
Science
Spine (lumbar)
Hypertension
Fractures
Hyperglicaemia
Subclinical hypercortisolism
Dyslipidemia
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Summary:Purpose To evaluate the prevalence of less severe hypercortisolism (LSH) in fractured patients, and its association with hypertension, hyperglicemia, dyslipidemia, and obesity. Method From July 2015 to October 2018 we enrolled all fractured patients admitted in our outpatient center for metabolic bone diseases, after exclusion of patients with secondary osteoporosis apart from diabetes and taking drugs known to affect bone metabolism. In all enrolled patients we collected data regarding gonadal status, history of diabetes, high blood pressure, dyslipidemia, and measured blood pressure, lipid profile, fasting glycaemia. Bone mass was measured with DXA at lumbar spine and femoral neck and the presence of fractures was evaluated with X-ray of thoracic and lumbar spine. All patients performed twice, 1 mg overnight dexametasone suppression test (DST) and, as confirmatory, 2day low-dose DST for diagnosing hypercortisolism. Results We enrolled 101 fractured patients (75 females, 26 males), aged 65 ± 10.3 years. Five out of 101 (5.0%) patients were diagnosed as LSH. Fifty-five (54.5%) out of 101 were hypertensive, 57 (56.4%) dyslipidemic, 17 (16.8%) hyperglicaemic, 28(27.7%) obese patients. LSH tended to be associated to blood hypertension [5/5 vs 50/96 (Fisher exact test, p  = 0.06) hypertensive patients]. Four out five LSH patients were hypogonadic. Conclusions Our study confirms that a nonnegligible percentage of fractured subjects actually presents an unrecognized hypercortisolism. Accordingly, regardless of age, we suggest to screen for hypercortisolism all patients with established osteoporosis and in particular hypertensive subjects.
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ISSN:1355-008X
1559-0100
DOI:10.1007/s12020-021-02616-1