Bone Health in Patients With Adrenal Adenomas and Hypercortisolism: A Multicenter Cross‐Sectional Study
Authors' conclusion
Patients with CS, and those with MACS and post-1mg-DST cortisol > 83 nmol/L, exhibited a higher burden of osteoporosis. However, only CS was associated with an elevated risk of symptomatic fragility fractures.
Study context
- Population
- Adults with adrenal adenomas (NFA, mild autonomous cortisol secretion (MACS), Cushing syndrome (CS)) and referent subjects without adrenal disorders, enrolled January 2019-September 2022; bone health questionnaire and DXA BMD within 12-months
- Participants
- 117 / 191 / 62 / 101
- Exposure
- NFA, MACS and CS vs referent subjects without adrenal disorders
- NFAn = 117
- MACSn = 191
- CSn = 62
- Referentsn = 101reference
- Outcome
- Prevalence of osteoporosis and symptomatic fragility fractures
Methodological detailsmulticenter, prospective enrollment, adjusted for age, sex, BMI, smoking status, alcohol use
- Multicenter
- Prospective enrollment
- Adjusted for age, sex, BMI, smoking status, alcohol use
Main finding
As reported in the abstract
Osteoporosis prevalence
Each group vs referentsOdds ratio (95% CI)
CS
3.0(1.1–8.3)
MACS
2.2(1.9–4.9)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Osteoporosis prevalence, MACS with post-1mg-DST cortisol > 83 nmol/LMACS, post-1mg-DST cortisol > 83 nmol/Lvs Referents | 3.2 (1.4–7.5) | |
| Osteoporosis prevalence, MACS with post-1mg-DST cortisol > 83 nmol/LMACS, post-1mg-DST cortisol > 83 nmol/Lvs NFA | 2.2 (1.1–4.4) | |
| Clinical fragility fractures prevalenceCSvs Referents | 6.1 (1.7–26.4) | |
| Clinical fragility fractures prevalenceCSvs NFA | 3.8 (1.3–11.2) | |
| Clinical fragility fractures prevalenceMACSvs Referents | 1.8 (0.6–6.9) | |
| Clinical fragility fractures prevalenceNFAvs Referents | 1.5 (0.4–6.1) | |
| 0.050.21520Odds ratio (log scale) |
Osteoporosis prevalence, MACS with post-1mg-DST cortisol > 83 nmol/L
- Among MACS, only those with post-1mg-DST cortisol > 83 nmol/L had higher osteoporosis prevalence
Clinical fragility fractures prevalence
- Fracture prevalence not associated with post-1mg-DST cortisol or frailty in MACS and NFA
Original publication
Bone Health in Patients With Adrenal Adenomas and Hypercortisolism: A Multicenter Cross‐Sectional Study. Clin Endocrinol (Oxf). Published 7 October 2025. doi:10.
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