Journal of International Medical Research (Jan 2018)

Effect of hypercortisolism on bone mineral density and bone metabolism: A potential protective effect of adrenocorticotropic hormone in patients with Cushing’s disease

  • Weihong Guo,
  • Fengao Li,
  • Chonggui Zhu,
  • Baoping Wang,
  • Kunling Wang,
  • Chenlin Dai,
  • Hongwei Jia,
  • Hongyan Wei,
  • Qing He,
  • Jin Cui,
  • Menghua Yuan,
  • Shaofang Tang,
  • Wei Liu,
  • Tiehong Zhu,
  • Zhihong Gao,
  • Fangqiu Zheng,
  • Zhongshu Ma,
  • Huiqi Qu,
  • Mei Zhu

DOI
https://doi.org/10.1177/0300060517725660
Journal volume & issue
Vol. 46

Abstract

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Objective To investigate the effects of Cushing’s disease (CD) and adrenal-dependent Cushing’s syndrome (ACS) on bone mineral density (BMD) and bone metabolism. Methods Data were retrospectively collected for 55 patients with hypercortisolism (CD, n = 34; ACS n = 21) from January 1997 to June 2014. BMD was examined in all patients, and bone turnover markers were tested in some patients. Healthy controls (n = 18) were also recruited. Results The lumbar spine and femoral neck BMD were significantly lower in the ACS and CD groups than in the control group. Lumbar BMD was significantly lower in the ACS than CD group. The collagen breakdown product (CTX) concentrations were significantly higher while the osteocalcin and procollagen type I N-terminal propeptide (PINP) concentrations were significantly lower in the ACS and CD groups than in the control group. The PINP concentration was significantly lower while the CTX concentration was significantly higher in the ACS than CD group. In the CD group only, lumbar BMD and serum adrenocorticotropic hormone had a significant positive correlation. Conclusions Bone turnover markers indicated suppressed osteoblast and enhanced osteoclast activities. PINP and CTX changes might indicate bone mass deterioration. Adrenocorticotropic hormone might be protective for lumbar BMD in patients with CD.