Mild autonomous cortisol secretion in adrenal incidentalomas and risk of fragility fractures: a large cross-sectional study
Authors' conclusion
A considerable fracture burden was shown in postmenopausal women with adrenal incidentalomas and MACS, with clinical implications for the evaluation and management of bone metabolism.
Study context
- Population
- Patients with adrenal incidentalomas, 1990–2019; vertebral fractures screened on spine X-rays or CT scans closest to first endocrine evaluation1,023 records reviewed
- Participants
- 735 patients
- Exposure
- Mild autonomous cortisol secretion (MACS) and adrenal Cushing's syndrome vs nonfunctioning adrenal incidentalomas
- Nonfunctioning (NF)n = 474reference
- MACSn = 238
- ACn = 23
- Outcome
- Prevalence of fragility fractures
Methodological detailsretrospective review of medical records
- Retrospective review of medical records
Main finding
As reported in the abstract
Fragility fracture prevalence
P = 0.012
- Prevalence differed between groups
- P = 0.018
Observational data: associations, not effects.
Further findings
| Outcome | NF | MACS | P value |
|---|---|---|---|
| Fragility fracture prevalence, postmenopausal womenMACS vs NF | 22.2% | 34.6% | P = 0.011 |
| Fragility fracture prevalence, women aged ≥65 yearsMACS vs NF | 29.5% | 48.8% | P < 0.01 |
Fragility fracture prevalence, males
- Fracture prevalence was similar in males
Factors associated with fragility fractures, postmenopausal women
- Age, OR
- 1.1, P < .001
- Smoking, OR
- 1.8, P = .048
- 1 mg-DST cortisol, OR
- 3.1, P = .029
Factors associated with fragility fractures, men
- Only age was associated with fragility fractures
Original publication
Mild autonomous cortisol secretion in adrenal incidentalomas and risk of fragility fractures: a large cross-sectional study. Eur J Endocrinol. Published 23 March 2023. doi:10.
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