scholarly journals Altered Bone Mass and Turnover in Female Patients with Adrenal Incidentaloma: The Effect of Subclinical Hypercortisolism

1999 ◽  
Vol 84 (7) ◽  
pp. 2381-2385 ◽  
Author(s):  
M. Torlontano ◽  
I. Chiodini ◽  
M. Pileri ◽  
G. Guglielmi ◽  
M. Cammisa ◽  
...  
Keyword(s):  
Bone Mass ◽  
Adrenal Incidentaloma ◽  
Subclinical Hypercortisolism ◽  
Female Patients

The effects of cortisol and adrenal androgen on bone mass in Asians with and without subclinical hypercortisolism

2019 ◽  
Vol 30 (5) ◽  
pp. 1059-1069
Author(s):  
S.H. Ahn ◽  
J. H. Kim ◽  
Y. Y. Cho ◽  
S. Suh ◽  
B.-J. Kim ◽  
...  
Keyword(s):  
Bone Mass ◽  
Subclinical Hypercortisolism ◽  
Adrenal Androgen

Risk of new vertebral fractures in patients with adrenal incidentaloma with and without subclinical hypercortisolism: A multicenter longitudinal study

2011 ◽  
Vol 26 (8) ◽  
pp. 1816-1821 ◽  
Author(s):  
Valentina Morelli ◽  
Cristina Eller-Vainicher ◽  
Antonio Stefano Salcuni ◽  
Francesca Coletti ◽  
Laura Iorio ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Vertebral Fractures ◽  
Adrenal Incidentaloma ◽  
Subclinical Hypercortisolism

scholarly journals Low Bone Mass and Osteoporosis in Women Referring themselves to Dual X-Ray Absorptiometry - Experience with a Health Promotion Action

2010 ◽  
Vol 3 (1) ◽  
pp. 29-33
Author(s):  
Gerhard W. Goerres ◽  
Jaap Swanenburg ◽  
Daniel Uebelhart
Keyword(s):  
Health Promotion ◽  
Bone Mass ◽  
The Self ◽  
Low Bone Mass ◽  
X Ray ◽  
Female Patients ◽  
Bmd Testing ◽  
Significant Difference ◽  
The Difference ◽  
Prevalence Of Osteoporosis

Aims: This retrospective analysis was done to describe the difference in the prevalence of osteoporosis/low bone mass between women referring themselves to bone mineral density (BMD) testing with dual X-ray absorptiometry (DXA) and women referred by their family practitioner. Methods: Women were recruited by a health promotion action in a Swiss weekly periodical and compared with female patients sent by their physician for DXA testing for various medical indications during the same period. Patients under steroid treatment, known previous fracture and undergoing follow-up for low bone mass were excluded. Self referred women were compared to female patients aged 40 years and older and the same evaluation was repeated for women aged 65 and older. Results: No differences were found in the prevalence of osteoporosis /low bone mass in women referred by their physician vs those who were self referred. However, a significant difference was found with age: the self referred women were 63.1 ± 8.6 years of age whereas the patient group’s mean age was 59.7 ± 9.4 (p=0.0001, 95% CI of the difference: 21 – 61 years). Conclusion: We suggest that health promotion actions might be able to recruit the correct candidates for BMD testing, since we found no significant difference in the prevalence of osteoporosis/ low bone mass between self referred and physician referred women. Our data further suggest that physicians may react earlier on their patient’s risk profiles than the time frame of action by the self-referred women.

scholarly journals Clinical and Biochemical Determinants of Bone Metabolism and Bone Mass in Adolescent Female Patients with Anorexia Nervosa

2002 ◽  
Vol 51 (4) ◽  
pp. 497-504 ◽  
Author(s):  
Laura Audí ◽  
Deisi M Vargas ◽  
Miquel Gussinyé ◽  
Diego Yeste ◽  
Gertrudis Martí ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Bone Mass ◽  
Bone Metabolism ◽  
Adolescent Female ◽  
Female Patients

scholarly journals Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion?

2020 ◽  
Vol 106 (1) ◽  
pp. e130-e139
Author(s):  
Valentina Morelli ◽  
Alberto Ghielmetti ◽  
Alice Caldiroli ◽  
Silvia Grassi ◽  
Francesca Marzia Siri ◽  
...  
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Verbal Fluency ◽  
Rating Scale ◽  
Adrenal Incidentaloma ◽  
Integrated Treatment ◽  
Subclinical Hypercortisolism ◽  
Tower Of London ◽  
Disability Score ◽  
Neurocognitive Functions

Abstract Context Cushing’s syndrome frequently causes mental health impairment. Data in patients with adrenal incidentaloma (AI) are lacking. Objective We aimed to evaluate psychiatric and neurocognitive functions in AI patients, in relation to the presence of subclinical hypercortisolism (SH), and the effect of adrenalectomy on mental health. Design We enrolled 62 AI patients (64.8 ± 8.9 years) referred to our centers. Subclinical hypercortisolism was diagnosed when cortisol after 1mg-dexamethasone suppression test was >50 nmol/L, in the absence of signs of overt hypercortisolism, in 43 patients (SH+). Interventions The structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders-5, and 5 psychiatric scales were performed. The Brief Assessment of Cognition in Schizophrenia (Verbal and Working Memory, Token and Symbol Task, Verbal Fluency, Tower of London) was explored in 26 patients (≤65 years). Results The prevalence of psychiatric disorders was 27.4% (SH+ 30.2% vs SH- 21.1%, P = 0.45). SH+ showed a higher prevalence of middle insomnia (by the Hamilton Depression Rating Scale) compared with SH- (51% vs 22%, P = 0.039). Considering the Sheehan Disability Scale, SH+ showed a higher disability score (7 vs 3, P = 0.019), higher perceived stress (4.2 ± 1.9 vs 2.9 ± 1.9, P = 0.015), and lower perceived social support (75 vs 80, P = 0.036) than SH-. High perceived stress was independently associated with SH (odds ratio [OR] = 5.46, confidence interval 95% 1.4–21.8, P = 0.016). Interestingly, SH+ performed better in verbal fluency (49.5 ± 38.9 vs 38.9 ± 9.0, P = 0.012), symbol coding (54.1 ± 6.7 vs 42.3 ± 15.5, P = 0.013), and Tower of London (15.1 vs 10.9, P = 0.009) than SH-. In 8 operated SH+, no significant changes were found. Conclusions Subclinical hypercortisolism may influence patients’ mental health and cognitive performances, requiring an integrated treatment.

The Role of Cortisol/ACTH Ratio for Screening of Subclinical Hypercortisolism in Patients with Adrenal Incidentalomas

2017 ◽  
Vol 126 (02) ◽  
pp. 71-76
Author(s):  
Lele Li ◽  
Guoqing Yang ◽  
Jingtao Dou ◽  
Weijun Gu ◽  
Zhaohui Lv ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Adrenal Incidentaloma ◽  
Serum Cortisol ◽  
Dexamethasone Suppression Test ◽  
Subclinical Hypercortisolism ◽  
Reliable Parameter ◽  
Suppression Test ◽  
Cortisol Levels ◽  
Dexamethasone Suppression

Abstract Introduction The cortisol/ACTH ratio was supposed to be helpful in the screening of subclinical hypercortisolism (SHC) in the published literatures. This study assessed the cortisol/ACTH ratio in patients with adrenal incidentaloma (AI) confirmed to have SHC and investigated its role for screening SCS in patients with AI. Methods This descriptive retrospective study included 183 patients with AIs [45 with SHC and 138 with non-functional adenoma (NFA)]. Cortisol and ACTH levels were measured at 8:00, 16:00, and 0:00, and the cortisol/ACTH ratio was calculated. ROC curve was used to evaluate efficacy of the cortisol/ACTH ratio, explore the best cut-off value and its corresponding sensitivity and specificity. Results The cortisol/ACTH ratios at all time points were significantly higher in the SHC group than the NFA group (P<0.05) and were significantly correlated with serum cortisol levels after the 1-mg dexamethasone suppression test (DST). Area Under the Curve (AUC) of the cortisol/ACTH ratio at 0:00 and midnight serum cortisol levels were 0.893 (0.843–0.943) and 0.831 (0.765–0.806), respectively. A cortisol/ACTH ratio at 0:00 cut-off of 32.18 nM/pM showed a sensitivity of 100% and specificity of 39.1%. The optimal cut-off was 68.83 nM/pM (sensitivity 86.7%, specificity 75.4%). Conclusions Patients with SHC have a higher cortisol/ACTH ratio than those with NFAs. The cortisol/ACTH ratio is significantly correlated with serum cortisol after the 1-mg DST. The diagnostic performance of the cortisol/ACTH ratio at 0:00 is superior to midnight serum cortisol. Therefore, the cortisol/ACTH ratio at 0:00 may be a reliable parameter for SHC screening in patient with AI.

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