Patients with adrenal incidentalomas and mild autonomous cortisol secretion may be at increased Risk of Vertebral Fractures

Incidence of VFx:

• In the longitudinal arm of the study, a cohort consisting of 66 patients without MACS and 60 patients with MACS was analyzed. Intriguingly, patients without MACS demonstrated a notably higher incidence of VFx at 36.4% compared to those with MACS, where the incidence was significantly lower at 10.0%.
• MACS continued to be associated with incident VFx, as reflected in a relative risk (RR) of 4.561, with a 95% CI spanning from 1.600 to 13.003, and a p-value of 0.005.
• This association remained consistent after adjusting for factors such as age, LS-BMD, gender distribution, the presence of prevalent VFx, and T2D.

Importantly, these associations held true when evaluating women and men separately. This study provides valuable insights into the increased risk of vertebral fractures in patients with adrenal incidentalomas and mild autonomous cortisol secretion (MACS). It underscores the importance of monitoring and managing bone health in these patients, irrespective of gender. Further research and clinical attention are warranted to better understand and address this heightened risk, ultimately improving patient outcomes.

Reference:

Favero, V., Eller-Vainicher, C., Morelli, V., Cairoli, E., Salcuni, A. S., Scillitani, A., Corbetta, S., Della Casa, S., Muscogiuri, G., Persani, L., & Chiodini, I. Increased risk of vertebral fractures in patients with mild autonomous cortisol secretion. The Journal of Clinical Endocrinology and Metabolism,2023 dgad560. https://doi.org/10.1210/clinem/dgad560