Prevalence of less severe hypercortisolism in fractured patients admitted in an outpatient clinic for metabolic bone diseases
| Autor: | Flavia Pugliese, Alfredo Scillitani, C. Columbu, F. Velluzzi, Giuseppe Guglielmi, Cristina Eller-Vainicher, Luca Giovanelli, Antonio Stefano Salcuni, Claudia Battista, Iacopo Chiodini, Vincenzo Carnevale |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism Osteoporosis 030209 endocrinology & metabolism Ambulatory Care Facilities Fractures Bone 03 medical and health sciences symbols.namesake Absorptiometry Photon 0302 clinical medicine Endocrinology Bone Density Diabetes mellitus Internal medicine Prevalence Humans Medicine Outpatient clinic Cushing Syndrome Fisher's exact test Femoral neck medicine.diagnostic_test business.industry medicine.disease medicine.anatomical_structure Blood pressure 030220 oncology & carcinogenesis symbols Female business Lipid profile Dyslipidemia |
| Zdroj: | Endocrine. 73:203-208 |
| ISSN: | 1559-0100 1355-008X |
| DOI: | 10.1007/s12020-021-02616-1 |
| Popis: | To evaluate the prevalence of less severe hypercortisolism (LSH) in fractured patients, and its association with hypertension, hyperglicemia, dyslipidemia, and obesity. 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. 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. 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. |
| Databáze: | OpenAIRE |
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