Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland.
Laboratory of Molecular Endocrinology, Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland.
Front Endocrinol (Lausanne). 2022 Nov 2;13:996157. doi: 10.3389/fendo.2022.996157. eCollection 2022.
Patients with primary adrenal insufficiency need lifelong replacement therapy with glucocorticoids and mineralocorticoids, which may influence their bone quality.
The aim of the study was to evaluate densitometry parameters, trabecular bone score and sclerostin concentrations in patients with primary adrenal insufficiency in comparison to control group.
We included 29 patients (62% females) with diagnose of autoimmune primary adrenal insufficiency (mean age 49.7 ± 11.7 years, mean duration of the disease 13.2± 13.6 years) and 33 healthy subjects (adjusted with age, sex and body mass index). Bone mineral density at the femoral neck, lumbar spine, total body and trabecular bone score were evaluated. Serum sclerostin concentrations were measured.
There were no significant differences in densitometry parameters (T-score, Z-score, bone mineral density in all locations) as well as in trabecular bone score in patients with adrenal insufficiency in comparison to control group. Mean serum sclerostin concentration was significantly higher in patients with adrenal insufficiency than in control group (44.7 ± 23.5 vs 30.7 ± 10.4 pmol/l, p=0.006). There was a negative correlation between trabecular bone score and the duration of adrenal insufficiency and age, also a negative correlation between femoral neck and total densitometry parameters and 24-hour urine cortisol as a marker of hydrocortisone daily dose in patients with adrenal insufficiency.
The bone status in patients with primary adrenal insufficiency was not impaired in comparison to control group, while sclerostin concentration was higher. The duration of the disease and higher hydrocortisone doses may affect negatively bone status.
原发性肾上腺功能不全患者需要终身接受糖皮质激素和盐皮质激素替代治疗，这可能会影响其骨质量。
本研究旨在评估原发性肾上腺功能不全患者与对照组相比的骨密度参数、骨小梁评分和骨硬化蛋白浓度。
我们纳入了 29 名（62%为女性）自身免疫性原发性肾上腺功能不全患者（平均年龄 49.7±11.7 岁，疾病平均病程 13.2±13.6 年）和 33 名健康对照者（按年龄、性别和体重指数调整）。评估了股骨颈、腰椎、全身和骨小梁的骨密度。测量了血清骨硬化蛋白浓度。
与对照组相比，原发性肾上腺功能不全患者的骨密度参数（T 评分、Z 评分、所有部位的骨密度）和骨小梁评分均无显著差异。原发性肾上腺功能不全患者的血清骨硬化蛋白浓度明显高于对照组（44.7±23.5 比 30.7±10.4 pmol/l，p=0.006）。骨小梁评分与肾上腺功能不全的病程和年龄呈负相关，与股骨颈和全身骨密度参数与作为氢化可的松日剂量标志物的 24 小时尿皮质醇呈负相关。
与对照组相比，原发性肾上腺功能不全患者的骨状况未受损，而骨硬化蛋白浓度较高。疾病的病程和较高的氢化可的松剂量可能会对骨状况产生负面影响。
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