Impact of mild autonomous cortisol secretion on bone density, metabolism, and microstructure: a cross-sectional study
Authors' conclusion
Patients with MACS have microstructural deterioration that may not be evident on routine DXA aBMD testing.
Study context
- Population
- Patients with mild autonomous cortisol secretion (MACS) and matched referent subjects, tertiary referral center, 2019–2022matched referents
- Participants
- 75 vs 75
- Exposure
- MACS vs matched referent subjects
- MACSn = 75
- Referentn = 75reference
- Outcome
- aBMD, TBS, osteocalcin and HR-pQCT trabecular BV/TV
Methodological detailsmatched (age, sex, gonadal status), single tertiary referral center
- Matched (age, sex, gonadal status)
- Single tertiary referral center
Main finding
As reported in the abstract
Trabecular bone score (TBS)
1.389 vs 1.475
P < 0.001
decreased TBS in MACS
Osteocalcin
17.1 vs 19.5 ng/mL
P = 0.030
lower osteocalcin in MACS
Trabecular BV/TV at tibia (high-resolution peripheral quantitative computed tomography (HR-pQCT))
0.220 vs 0.233
P = 0.015
reduced in MACS
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Multivariable analysis: association of MACS with lower bone parametersMACSvs ReferentMultivariable analysis | OR per SD decrease in TBS 2.87 (CI 1.65–5.00) | |
| Multivariable analysis: association of MACS with lower bone parametersMACSvs ReferentMultivariable analysis | OR per SD decrease in trabecular BV/TV at radius 2.58 (CI 1.33–5.00) | |
| Multivariable analysis: association of MACS with lower bone parametersMACSvs ReferentMultivariable analysis | OR per SD decrease in trabecular BV/TV at tibia 4.06 (CI 2.10–7.86) | |
| 0.10.31310Ratio (log scale) |
Original publication
Impact of mild autonomous cortisol secretion on bone density, metabolism, and microstructure: a cross-sectional study. J Clin Endocrinol Metab. Published 16 April 2026. doi:10.
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