Vertebral fractures may occur early in the history of Cushing disease associating with male gender and degree of cortisol secretion
Authors' conclusion
VFs may occur in newly diagnosed, short-duration CD and are independently associated with male gender and cortisol excess. A cortisol threshold > 173 ng/mL may help identify patients at increased skeletal risk.
Study context
- Population
- Adults with newly diagnosed Cushing disease (CD) admitted for first transsphenoidal surgery
- Participants
- 175 adults
- Exposure
- Patients with vertebral fractures (VFs) vs without VFs
- VFsn = 41
- Outcome
- Prevalence of vertebral fractures (morphometric analysis of preoperative lateral chest X-rays)
- Follow-up
- Preoperative
Main finding
As reported in the abstract
Prevalence of VFs
VFs detected
41 patients
23.4%
Multiple fractures among VFs
56.1%
Severe fractures among VFs
31.7%
Median estimated disease duration
12 months
Observational data: associations, not effects.
Further findings
Serum cortisol · higher with VFs
P = 0.034
- Serum cortisol — Cortisol cut-off predicting VFs
- > 173 ng/mL
Independent risk factors for VFs (multivariate analysis)
- Male gender and cortisol > 173 ng/mL were independent risk factors for VFs
Other associations
- VFs associated with glycemic alterations and hypogonadism
- Spine Deformity Index correlated positively with cortisol
- Higher cortisol with multiple or severe VFs
Postoperative cortisol after overnight 1-mg dexamethasone suppression test
- Significantly higher in patients with VFs; higher rate of cortisol > 18 ng/mL with VFs
Original publication
Vertebral fractures may occur early in the history of Cushing disease associating with male gender and degree of cortisol secretion. Pituitary. Published 15 April 2026. doi:10.
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