Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
Departments of Clinical Medicine, Endocrinology and Diabetes, Aarhus University, Aarhus, Denmark.
Eur J Endocrinol. 2021 Apr;184(4):597-606. doi: 10.1530/EJE-20-1396.
Several small studies reported increased prevalence and incidence of asymptomatic vertebral fractures in patients with non-functioning adrenal adenomas and adenomas with mild autonomous cortisol secretion. However, the risk of symptomatic fractures at vertebrae, and at other sites remains unknown. Our objective was to determine the prevalence and incidence of symptomatic site-specific fractures in patients with adrenal adenomas.
Population-based cohort study, Olmsted County, Minnesota, USA, 1995-2017.
Participants were the patients with adrenal adenoma and age/sex-matched referent subjects. Patients with overt hormone excess were excluded. Main outcomes measures were prevalence and incidence of bone fractures.
Of 1004 patients with adrenal adenomas, 582 (58%) were women, and median age at diagnosis was 63 years (20-96). At the time of diagnosis, patients had a higher prevalence of previous fractures than referent subjects (any fracture: 47.9% vs 41.3%, P = 0.003, vertebral fracture: 6.4% vs 3.6%, P = 0.004, combined osteoporotic sites: 16.6% vs 13.3%, P = 0.04). Median duration of follow-up was 6.8 years (range: 0-21.9 years). After adjusting for age, sex, BMI, tobacco use, prior history of fracture, and common causes of secondary osteoporosis, patients with adenoma had hazard ratio of 1.27 (95% CI: 1.07-1.52) for developing a new fracture during follow up when compared to referent subjects.
Patients with adrenal adenomas have higher prevalence of fractures at the time of diagnosis and increased risk to develop new fractures when compared to referent subjects.
一些小型研究报告称，无功能肾上腺腺瘤和轻度自主皮质醇分泌腺瘤患者的无症状性椎体骨折发生率和患病率有所增加。但是，椎体和其他部位的症状性骨折风险尚不清楚。我们的目的是确定患有肾上腺腺瘤的患者的症状性特定部位骨折的患病率和发生率。
基于人群的队列研究，美国明尼苏达州奥姆斯特德县，1995-2017 年。
参与者为患有肾上腺腺瘤的患者和年龄/性别匹配的参照受试者。排除有明显激素过多的患者。主要结局指标是骨折的患病率和发生率。
在 1004 例肾上腺腺瘤患者中，有 582 例（58%）为女性，诊断时的中位年龄为 63 岁（20-96 岁）。在诊断时，患者的既往骨折患病率高于参照受试者（任何骨折：47.9%比 41.3%，P=0.003；椎体骨折：6.4%比 3.6%，P=0.004；骨质疏松性综合部位：16.6%比 13.3%，P=0.04）。中位随访时间为 6.8 年（范围：0-21.9 年）。在校正年龄、性别、BMI、吸烟状况、既往骨折史和继发性骨质疏松症的常见病因后，与参照受试者相比，腺瘤患者在随访期间发生新骨折的风险比为 1.27（95%CI：1.07-1.52）。
与参照受试者相比，患有肾上腺腺瘤的患者在诊断时骨折的患病率更高，发生新骨折的风险更高。
