van der Eerden A W, den Heijer M, Oyen W J, Hermus A R
Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Neth J Med. 2007 Apr;65(4):137-41.
Patients with Cushing's syndrome have a high prevalence of osteoporotic fractures. Little is known about factors determining bone mineral density (BMD) in these patients.
To evaluate which factors influence BMD at the time of diagnosis of Cushing's syndrome.
In 77 consecutive patients with Cushing's syndrome with a median age of 41.1 (interquartile range 31.1 to 52.2) years we measured BMD of the lumbar spine and the femoral neck at the time of diagnosis. From the medical records we obtained information on possible predictors of BMD. We compared BMD with a reference population by means of the Z score. Adjustment for other variables than age and sex was made with linear regression models.
Patients with Cushing's syndrome had a low Z score in both the lumbar spine (-1.07 SD (95% CI -1.43 to -0.71 SD )) and in the femoral neck (-0.81 SD (95% CI -1.06 to -0.55 SD )). 82% of patients had osteopenia at one or both sites (T score lower than -1 SD ), including 31% with osteoporosis (T score -2.5 SD or lower). The main determinant of the Z score at both sites and for both sexes was age. Z score increased by about 0.4 SD per decade. 81% of patients.
库欣综合征患者骨质疏松性骨折的患病率很高。对于决定这些患者骨密度（BMD）的因素知之甚少。
评估哪些因素在库欣综合征诊断时影响骨密度。
在77例连续的库欣综合征患者中，中位年龄为41.1岁（四分位间距31.1至52.2岁），我们在诊断时测量了腰椎和股骨颈的骨密度。从病历中我们获取了关于骨密度可能预测因素的信息。我们通过Z评分将骨密度与参考人群进行比较。使用线性回归模型对年龄和性别以外的其他变量进行调整。
库欣综合征患者在腰椎（-1.07标准差（95%可信区间-1.43至-0.71标准差））和股骨颈（-0.81标准差（95%可信区间-1.06至-0.55标准差））的Z评分均较低。82%的患者在一个或两个部位存在骨量减少（T评分低于-1标准差），其中31%患有骨质疏松症（T评分-2.5标准差或更低）。两个部位以及男女的Z评分的主要决定因素是年龄。每十年Z评分增加约0.4标准差。81%的患者。
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