PMID- 32154561
OWN - NLM
STAT- MEDLINE
DCOM- 20210209
LR  - 20240328
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 105
IP  - 5
DP  - 2020 May 1
TI  - The Impact of Mild Autonomous Cortisol Secretion on Bone Turnover Markers.
PG  - 1469-77
LID - dgaa120 [pii]
LID - 10.1210/clinem/dgaa120 [doi]
AB  - CONTEXT: Several studies have reported increased risk of fragility fractures in 
      patients with mild autonomous cortisol secretion (MACS), discordant to the degree 
      of bone density deterioration. OBJECTIVE: To evaluate the effect of MACS on bone 
      metabolism in patients with adrenal adenomas. DESIGN: Cross-sectional study with 
      prospective enrollment, 2014-2019. SETTING: Referral center. PATIENTS: 213 
      patients with adrenal adenomas: 22 Cushing syndrome (CS), 92 MACS and 99 
      nonfunctioning adrenal tumors (NFAT). MAIN OUTCOME MEASURES: Osteocalcin, 
      procollagen I intact N-terminal (PINP), C-terminal telopeptide (CTX), sclerostin. 
      RESULTS: Patients with CS demonstrated lower markers of bone formation compared 
      with patients with MACS and NFAT (CS vs MACS vs NFAT: mean osteocalcin 14.8 vs 
      20.1 vs 21.3 ng/mL [P < 0.0001]; mean PINP 34.8 vs 48.7 vs 48.5 microg/L 
      [P = 0.003]). Severity of cortisol excess was inversely associated with 
      sclerostin (CS vs MACS vs NFAT: mean sclerostin 419 vs 538 vs 624 ng/L, 
      [P < 0.0001]). In a multivariable model of age, sex, body mass index, cortisol, 
      and bone turnover markers, sclerostin was a significant predictor of low bone 
      mass in patients with MACS (OR 0.63 [CI 95%, 0.40-0.98] for each 100 ng/L of 
      sclerostin increase).After adrenalectomy, osteocalcin, CTX, and sclerostin 
      increased by a mean difference of 6.3 ng/mL, 0.12 ng/mL, and 171 pg/mL (P = 0.02 
      for all), respectively. CONCLUSIONS: Lower sclerostin level in patients with MACS 
      reflects a reduction in osteocyte function or number associated with exposure to 
      chronic cortisol excess. Increase in bone turnover markers after adrenalectomy 
      suggests restoration of favorable bone metabolism.
CI  - (c) Endocrine Society 2020. All rights reserved. For permissions, please e-mail: 
      journals.permissions@oup.com.
FAU - Athimulam, Shobana
AU  - Athimulam S
AD  - Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 
      Rochester, Minnesota.
FAU - Delivanis, Danae
AU  - Delivanis D
AD  - Division of Endocrinology, University of Patras, Rio Patras, Greece.
FAU - Thomas, Melinda
AU  - Thomas M
AD  - Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 
      Rochester, Minnesota.
FAU - Young, William F
AU  - Young WF
AD  - Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 
      Rochester, Minnesota.
FAU - Khosla, Sundeep
AU  - Khosla S
AD  - Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 
      Rochester, Minnesota.
FAU - Drake, Matthew T
AU  - Drake MT
AD  - Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 
      Rochester, Minnesota.
FAU - Bancos, Irina
AU  - Bancos I
AD  - Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 
      Rochester, Minnesota.
LA  - eng
GR  - K23 DK121888/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Adaptor Proteins, Signal Transducing)
RN  - 0 (Biomarkers)
RN  - 0 (Collagen Type I)
RN  - 0 (Peptides)
RN  - 0 (Procollagen)
RN  - 0 (SOST protein, human)
RN  - 0 (collagen type I trimeric cross-linked peptide)
RN  - 104982-03-8 (Osteocalcin)
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Adaptor Proteins, Signal Transducing/blood
MH  - Adenoma/metabolism/pathology
MH  - Adolescent
MH  - Adrenal Gland Neoplasms/metabolism/pathology
MH  - Adult
MH  - Biomarkers/analysis/*blood
MH  - Bone Remodeling/physiology
MH  - Bone and Bones/*metabolism
MH  - Collagen Type I/blood
MH  - Cross-Sectional Studies
MH  - Cushing Syndrome/metabolism
MH  - Female
MH  - Humans
MH  - Hydrocortisone/blood/*metabolism
MH  - Male
MH  - Middle Aged
MH  - Minnesota
MH  - Osteocalcin/blood
MH  - Paraneoplastic Endocrine Syndromes/*metabolism
MH  - Peptides/blood
MH  - Procollagen/blood
MH  - Severity of Illness Index
MH  - Young Adult
PMC - PMC7108681
MID - NIHMS1584383
OTO - NOTNLM
OT  - Cushing syndrome
OT  - MACS
OT  - bone turnover markers
OT  - nonfunctioning adrenal tumors
OT  - osteopenia
OT  - osteoporosis
OT  - sclerostin
EDAT- 2020/03/11 06:00
MHDA- 2021/02/10 06:00
PMCR- 2021/03/10
CRDT- 2020/03/11 06:00
PHST- 2020/01/08 00:00 [received]
PHST- 2020/03/05 00:00 [accepted]
PHST- 2020/03/11 06:00 [pubmed]
PHST- 2021/02/10 06:00 [medline]
PHST- 2020/03/11 06:00 [entrez]
PHST- 2021/03/10 00:00 [pmc-release]
AID - 5802410 [pii]
AID - dgaa120 [pii]
AID - 10.1210/clinem/dgaa120 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2020 May 1;105(5):1469-77. doi: 10.1210/clinem/dgaa120.