オオツキ ミチオ   Michio Otsuki
  大月 道夫
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess.
掲載誌名 正式名:International journal of endocrinology
略  称:Int J Endocrinol
ISSNコード:16878337/16878337
掲載区分国外
巻・号・頁 2022,pp.5009395
著者・共著者 Izawa Shoichiro, Matsumoto Kazuhisa, Matsuzawa Kazuhiko, Katabami Takuyuki, Yoshimoto Takanobu, Otsuki Michio, Sone Masakatsu, Takeda Yoshiyu, Okamura Shintaro, Ichijo Takamasa, Tsuiki Mika, Suzuki Tomoko, Naruse Mitsuhide, Tanabe Akiyo
発行年月 2022
概要 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.
DOI 10.1155/2022/5009395
PMID 35340678