Skeletal differences in bone mineral area and content before and after cure of endogenous Cushing's syndrome

L. Füto, J. Toke, A. Patócs, Á Szappanos, I. Varga, E. Gláz, Z. Tulassay, K. Rácz, M. Tóth

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Abstract

Summary: We examined bone densitometric data in a four-year follow-up period before and after the cure of CS. Plasma cortisol concentrations were similar, but the duration of estimated glucocorticoid excess was longer in patients with prevalent bone fractures compared to those without fractures. After therapy of CS, bone area, BMC and BMD increased significantly at the LS and femur during follow-up, but they decreased at the forearm, suggesting redistribution of bone minerals from the peripheral to the axial skeleton. Introduction: Only a few studies report the changes in bone mineral density (BMD) after the cure of Cushing's syndrome (CS). Methods: Forty-one patients with Cushing's disease, 21 patients with adrenal CS and 6 patients with ectopic CS were prospectively enrolled. BMD, bone mineral content (BMC) and bone area were measured by DXA. Results: No significant correlations were found between serum cortisol concentrations and baseline bone densitometric data. After successful therapy of CS, bone area and BMD increased significantly at the lumbar spine (LS) and femur during follow-up, but they decreased at the forearm. The progressive increase in BMC at the LS had a significant negative correlation with the change of the BMC of radius in the first and second follow-up years. The change in the body mass index was an independent predictor for changes in BMC both at the LS and at the forearm at the second year of remission. Conclusions: The regional differences and the time-dependent changes of BMC suggest that the source of marked increase in axial BMC after the cure of CS is, at least partly, due to the redistribution of bone minerals from the peripheral to the axial skeleton.

Original languageEnglish
Pages (from-to)941-949
Number of pages9
JournalOsteoporosis International
Volume19
Issue number7
DOIs
Publication statusPublished - júl. 2008

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Cushing Syndrome
Bone Density
Bone and Bones
Spine
Forearm
Skeleton
Femur
Minerals
Hydrocortisone
Pituitary ACTH Hypersecretion
Bone Fractures
Glucocorticoids
Body Mass Index

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Skeletal differences in bone mineral area and content before and after cure of endogenous Cushing's syndrome",
abstract = "Summary: We examined bone densitometric data in a four-year follow-up period before and after the cure of CS. Plasma cortisol concentrations were similar, but the duration of estimated glucocorticoid excess was longer in patients with prevalent bone fractures compared to those without fractures. After therapy of CS, bone area, BMC and BMD increased significantly at the LS and femur during follow-up, but they decreased at the forearm, suggesting redistribution of bone minerals from the peripheral to the axial skeleton. Introduction: Only a few studies report the changes in bone mineral density (BMD) after the cure of Cushing's syndrome (CS). Methods: Forty-one patients with Cushing's disease, 21 patients with adrenal CS and 6 patients with ectopic CS were prospectively enrolled. BMD, bone mineral content (BMC) and bone area were measured by DXA. Results: No significant correlations were found between serum cortisol concentrations and baseline bone densitometric data. After successful therapy of CS, bone area and BMD increased significantly at the lumbar spine (LS) and femur during follow-up, but they decreased at the forearm. The progressive increase in BMC at the LS had a significant negative correlation with the change of the BMC of radius in the first and second follow-up years. The change in the body mass index was an independent predictor for changes in BMC both at the LS and at the forearm at the second year of remission. Conclusions: The regional differences and the time-dependent changes of BMC suggest that the source of marked increase in axial BMC after the cure of CS is, at least partly, due to the redistribution of bone minerals from the peripheral to the axial skeleton.",
keywords = "Dual-energy X-ray absorptiometry, Endogenous Cushing's syndrome, Fractures, Redistribution of bone minerals after cure",
author = "L. F{\"u}to and J. Toke and A. Pat{\'o}cs and {\'A} Szappanos and I. Varga and E. Gl{\'a}z and Z. Tulassay and K. R{\'a}cz and M. T{\'o}th",
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TY - JOUR

T1 - Skeletal differences in bone mineral area and content before and after cure of endogenous Cushing's syndrome

AU - Füto, L.

AU - Toke, J.

AU - Patócs, A.

AU - Szappanos, Á

AU - Varga, I.

AU - Gláz, E.

AU - Tulassay, Z.

AU - Rácz, K.

AU - Tóth, M.

PY - 2008/7

Y1 - 2008/7

N2 - Summary: We examined bone densitometric data in a four-year follow-up period before and after the cure of CS. Plasma cortisol concentrations were similar, but the duration of estimated glucocorticoid excess was longer in patients with prevalent bone fractures compared to those without fractures. After therapy of CS, bone area, BMC and BMD increased significantly at the LS and femur during follow-up, but they decreased at the forearm, suggesting redistribution of bone minerals from the peripheral to the axial skeleton. Introduction: Only a few studies report the changes in bone mineral density (BMD) after the cure of Cushing's syndrome (CS). Methods: Forty-one patients with Cushing's disease, 21 patients with adrenal CS and 6 patients with ectopic CS were prospectively enrolled. BMD, bone mineral content (BMC) and bone area were measured by DXA. Results: No significant correlations were found between serum cortisol concentrations and baseline bone densitometric data. After successful therapy of CS, bone area and BMD increased significantly at the lumbar spine (LS) and femur during follow-up, but they decreased at the forearm. The progressive increase in BMC at the LS had a significant negative correlation with the change of the BMC of radius in the first and second follow-up years. The change in the body mass index was an independent predictor for changes in BMC both at the LS and at the forearm at the second year of remission. Conclusions: The regional differences and the time-dependent changes of BMC suggest that the source of marked increase in axial BMC after the cure of CS is, at least partly, due to the redistribution of bone minerals from the peripheral to the axial skeleton.

AB - Summary: We examined bone densitometric data in a four-year follow-up period before and after the cure of CS. Plasma cortisol concentrations were similar, but the duration of estimated glucocorticoid excess was longer in patients with prevalent bone fractures compared to those without fractures. After therapy of CS, bone area, BMC and BMD increased significantly at the LS and femur during follow-up, but they decreased at the forearm, suggesting redistribution of bone minerals from the peripheral to the axial skeleton. Introduction: Only a few studies report the changes in bone mineral density (BMD) after the cure of Cushing's syndrome (CS). Methods: Forty-one patients with Cushing's disease, 21 patients with adrenal CS and 6 patients with ectopic CS were prospectively enrolled. BMD, bone mineral content (BMC) and bone area were measured by DXA. Results: No significant correlations were found between serum cortisol concentrations and baseline bone densitometric data. After successful therapy of CS, bone area and BMD increased significantly at the lumbar spine (LS) and femur during follow-up, but they decreased at the forearm. The progressive increase in BMC at the LS had a significant negative correlation with the change of the BMC of radius in the first and second follow-up years. The change in the body mass index was an independent predictor for changes in BMC both at the LS and at the forearm at the second year of remission. Conclusions: The regional differences and the time-dependent changes of BMC suggest that the source of marked increase in axial BMC after the cure of CS is, at least partly, due to the redistribution of bone minerals from the peripheral to the axial skeleton.

KW - Dual-energy X-ray absorptiometry

KW - Endogenous Cushing's syndrome

KW - Fractures

KW - Redistribution of bone minerals after cure

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AN - SCOPUS:44649087682

VL - 19

SP - 941

EP - 949

JO - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

IS - 7

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