The effects of cortisol and adrenal androgen on bone mass in Asians with and without subclinical hypercortisolism

Ahn, Seong Hee; Kim, J H; Cho, Y Y; Suh, Sunghwan; Kim, BJ; Hong, Seongbin; Lee, Seung Hun; Koh, Jung‐Min; Song, Ki–Whan

doi:10.1007/s00198-019-04871-5

Cited by 14 publications

(31 citation statements)

References 29 publications

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“…The researchers found an inverse correlation between 1 mg DST and TBS. Moreover, an association of higher cortisol/DHEA-S ratio with lower TBS was observed in women 43 , which is congruent with Ahn’s results regarding BMD 38 . Reduced androgens that are usually associated with ACS have a deteriorating effect on bone and vertebral fractures; additionally, a DHEA-S increase may have a counterbalancing effect on deleterious results of hypercortisolism 38 39 43 .…”

Section: Introductionsupporting

confidence: 89%

“…Ahn et al in 2019 described the Asian population based on the data collected from almost 800 patients. They discovered that women with mACS, regardless of the gonadal status, had lower BMD at the lumbar spine, but only premenopausal women had lower BMD at the hip compared to patients without mACS 38 . Similar findings were described in the Caucasian population 20 .…”

Section: Introductionmentioning

confidence: 99%

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Comorbidities in Mild Autonomous Cortisol Secretion – A Clinical Review of Literature

Czapla-Iskrzycka

Świątkowska−Stodulska

Sworczak

2022

Exp Clin Endocrinol Diabetes

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Mild autonomous cortisol secretion (mACS) is a state of cortisol excess usually associated with existence of adrenal incidentaloma. Because of the lack of symptoms of the disease, the biochemical evaluation is the most important to determine a diagnosis. However, scientific societies have different diagnostic criteria for mACS, which makes the treatment of this disease and using results of original papers in daily practice more difficult. Chronic hypercortisolemic state, even if mild, may lead to diseases that are mostly connected with overt Cushing’s syndrome. Some of them can cause a higher mortality of patients with mACS and those problems need to be addressed. In this review we describe the comorbidities associated with mACS: cardiovascular disorders, arterial hypertension, diabetes mellitus, insulin resistance, dyslipidemia, obesity, metabolic syndrome, non-alcoholic fatty liver disease, vertebral fractures and osteoporosis. The point of this paper is to characterise them and determine if and how these conditions should be managed. Two databases – PubMed and Web of Science were searched. Even though the evidence are scarce, this is an attempt to lead clinicians through the problems associated with this enigmatic condition.

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Section: Introductionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Comorbidities in Mild Autonomous Cortisol Secretion – A Clinical Review of Literature

Czapla-Iskrzycka

Świątkowska−Stodulska

Sworczak

2022

Exp Clin Endocrinol Diabetes

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“…Tauchmanova et al reported that vertebral fractures were common in female patients with CE regardless of the severity [ 18 ]. Adrenal androgen plays an important role in osteoblast activation, bone mass, and bone quality, especially in women [ 4 , 7 , 8 , 19 , 20 ]. In the present study, not including patients with ACTH-dependent CS, CE, and female sex were positively associated with developing OS/OP ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Adrenal CS is typically caused by CE originating from adrenocortical neoplasms, and the production of ACTH is suppressed by excess cortisol [ 1 , 2 ]. Suppressed ACTH also decreases the endogenous production of adrenal androgens [ 3 , 4 ]. Iatrogenic CS is induced by the therapeutic administration of synthetic glucocorticoids, causing suppression of endogenous ACTH and adrenal androgens.…”

Section: Introductionmentioning

confidence: 99%

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Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess

Izawa

Matsumoto

Matsuzawa

et al. 2022

International Journal of Endocrinology

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Objective. Osteoporosis and osteopenia (OS/OP) are frequent in patients with adrenal adenomas associated with cortisol excess (CE). However, the relationship between OS/OP and CE severity considering sex differences is unknown. Design. A cross-sectional observational study from January 2006 to December 2015. Patients. 237 patients with adrenal adenoma associated with CE, including Cushing’s syndrome and mild autonomous cortisol secretion (MACS), diagnosed in 10 referral centers in Japan. MACS was defined by 1 mg overnight dexamethasone suppression test (DST) cortisol level >1.8 μg/dL. Measurements. Prevalence of fragility fractures, medication for osteoporosis, and bone mineral density. Results. In total, 112 of 237 patients, who were predominantly female ( P < 0.001 ) and had lower BMI ( P = 0.013 ), had OS/OP. Patients with OS/OP was significantly affected by CE ( P < 0.01 ) than those without. The adjusted odds ratio (OR) for predicting OS/OP was obtained in multivariate logistic regression analysis. Clinical measures of CE, 1 mg DST cortisol levels, were positively associated with OS/OP in total cases (OR 1.124, 95% CI: 1.070–1.181, P < 0.001 ) and the cases with MACS (OR 1.156, 95%CI: 1.046–1.278, P = 0.005 ). A cutoff value of 1 mg DST cortisol level >5.0 μg/dL was associated with OS/OP differently between men and women. OS/OP risk in men with MACS was significantly affected only by 1 mg DST cortisol levels. However, OS/OP risk in women with MACS was significantly affected by 1 mg DST cortisol levels and age. Conclusions. CE severity in adrenal adenoma is positively associated with OS/OP. However, the associated factors of OS/OP in the patients with MACS are different between men and women.

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Unveiling the hidden impact: Subclinical hypercortisolism and its subtle influence on bone health

Lou,

Ren,

Chen

et al. 2024

Aging Medicine

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In recent years, advancements in imaging technologies have led to an increased detection rate of adrenal incidentalomas (AI), with age demonstrating a significant correlation with their incidence. Among the various forms of functional adrenal incidentalomas, subclinical hypercortisolism (SH) stands out as a predominant subtype. Despite the absence of typical symptoms associated with Cushing's syndrome, both domestic and international research consistently establishes a robust link between SH and diverse metabolic irregularities, including hypertension, lipid metabolism disorders, glucose metabolism abnormalities, and disruptions in bone metabolism. Individuals with SH face an elevated risk of cardiovascular events and mortality, highlighting the clinical significance of addressing this condition. Prolonged exposure to elevated cortisol levels poses a significant threat to bone health, contributing to bone loss, alterations in bone microstructure, and an increased susceptibility to fractures. However, comprehensive reviews addressing bone metabolism changes and associated mechanisms in SH patients are currently lacking. Furthermore, the profound impact of concurrent SH on the overall health of the elderly cannot be overstated. A comprehensive understanding of the skeletal health status in elderly individuals with concomitant SH is imperative. This article aims to fill this gap by offering a detailed review of bone metabolism changes and associated mechanisms in SH patients arising from AI. Additionally, it provides a forward‐looking perspective on research concerning skeletal health in elderly individuals with concurrent SH.

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The effects of cortisol and adrenal androgen on bone mass in Asians with and without subclinical hypercortisolism

Cited by 14 publications

References 29 publications

Comorbidities in Mild Autonomous Cortisol Secretion – A Clinical Review of Literature

Comorbidities in Mild Autonomous Cortisol Secretion – A Clinical Review of Literature

Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess

Unveiling the hidden impact: Subclinical hypercortisolism and its subtle influence on bone health

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