Persistent improvement of bone mineral density up to 20 years after treatment of Cushing's syndrome
| Autor: | Ad R. M. M. Hermus, Romana T. Netea-Maier, Sean H. P. P. Roerink, Pepijn van Houten, Margreet Wagenmakers, Annenienke C van de Ven |
|---|---|
| Přispěvatelé: | Internal Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Endocrinology Diabetes and Metabolism Urinary system Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Osteoporosis Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9] Cohort Studies Excretion Fractures Bone Young Adult Endocrinology SDG 3 - Good Health and Well-being Bone Density Internal medicine medicine Humans Longitudinal Studies Cushing Syndrome Aged Netherlands Retrospective Studies Aged 80 and over Bone mineral business.industry Incidence Incidence (epidemiology) Confounding General Medicine Middle Aged medicine.disease Bone Diseases Metabolic Cross-Sectional Studies lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] Etiology Female business After treatment Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] |
| Zdroj: | European Journal of Endocrinology, 185(2), 241-250. Bioscientifica Ltd European Journal of Endocrinology, 185, 2, pp. 241-250 European Journal of Endocrinology, 185, 241-250 |
| ISSN: | 0804-4643 |
| Popis: | Objective Cushing’s syndrome (CS) is associated with osteoporosis and high fracture risk. Besides male sex, it is unknown which variables influence bone mineral density (BMD) at diagnosis and it is unclear to what extent BMD normalizes during long-term follow-up after treatment of CS. The aim of this study was to determine factors associated with BMD at diagnosis of CS and to determine the long-term course of BMD and fracture rate after successful treatment of CS. Design Retrospective cross-sectional and longitudinal cohort study. Methods Data were collected from 231 patients with CS who were treated at the Radboud University Medical Centre between 1968 and 2020. Results At diagnosis, male sex was associated with lower Z-scores at the lumbar spine (LS) compared with female sex: −0.97s.d. (−1.45 to −0.49) after correction for possible confounders. Shorter duration of symptoms and younger age were also associated with lower Z-scores at diagnosis, while etiology of CS, urinary cortisol excretion and gonadal status were not associated with Z-scores at diagnosis. Z-scores improved up to 20 years after treatment. Fifteen years after treatment, men showed larger improvements of Z-scores than women; +2.56 (1.82–3.30) increase in LS Z-score vs +1.48 (0.96–2.00) respectively. Fracture incidence was highest during the 2 years before diagnosis and decreased after treatment. Conclusion Male sex, younger age and shorter duration of symptoms are associated with lower BMD at diagnosis of CS. BMD continues to improve up to 20 years after treatment of CS. Fracture rate decreases after treatment of CS. |
| Databáze: | OpenAIRE |
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