Profiles of Endogenous Circulating Cortisol and Bone Mineral Density in Healthy Elderly Men

Abstract

Exogenous glucocorticoids are known to increase the risk of osteoporosis. However, the contribution made by endogenous circulating cortisol concentrations to adult skeletal status remains unknown. We examined this issue in a sample of 34 healthy men, aged 61-72 yr. Venous blood samples were obtained under standard conditions every 20 min over a 24-h period. Measurements were made of serum cortisol and cortisol-binding globulin. Bone mineral density was measured at the lumbar spine and proximal femur using dual energy x-ray absorptiometry. Measurements were made at baseline and 4 yr later. There was a weak negative association between integrated cortisol concentration and lumbar spine bone density (r = -0.37; P < 0.05); similar relationships (P < 0.05) existed at three of five proximal femoral sites. There were also statistically significant positive associations between the trough cortisol concentration and bone loss rate at the lumbar spine (r = 0.38; P < 0.05), femoral neck (r = 0.47; P < 0.001), and the trochanteric region (r = 0.41; P = 0.02) over the 4-yr follow-up period. The cross-sectional relationships between cortisol concentration and bone density were removed by adjustment for body mass index, but the influence on bone loss rate remained significant after adjusting for adiposity, cigarette smoking, alcohol consumption, dietary calcium intake, physical activity, and serum testosterone and estradiol levels. These observations suggest that the endogenous cortisol profile of healthy elderly men is a determinant of their bone mineral density and their rate of involutional bone loss.

Bone formation is not impaired by hibernation (disuse) in black bears Ursus americanus

“…In humans, high serum concentrations of cortisol, as well as glucocorticoid therapy, are associated with increased bone resorption and decreased bone formation, which decrease bone mass and increase the incidence of spontaneous fracture (Libanati and Baylink, 1992). Additionally, a significant negative correlation between serum cortisol levels and bone mineral density has been shown in men (Dennison et al, 1999). These findings suggest a role for cortisol in the regulation of bone turnover in hibernating bears.…”

Energy Restriction Reduces Fractional Calcium Absorption in Mature Obese and Lean Rats

“…Because elevated levels of glucocorticoid hormones are a risk factor for bone loss (31,32) and have recently been shown to be associated with calcium absorption (15), this may be one important mediator of the negative effects of weight reduction on calcium and bone metabolism.…”

Symptoms of anxiety or depression and risk of fracture in older people: the Hertfordshire Cohort Study

“…24,25 This dysregulation of the HPA axis may have implications for osteoporosis: in small samples of older people, higher plasma cortisol was associated with lower baseline BMD and greater rate of bone loss over a four-year period. 26,27 In the present study, we examined whether lower BMD might account for the association between probable anxiety and fracture in men, but we found no evidence of a trend between increasing symptoms of anxiety and lower BMD.…”