Giordano Roberta, Parasiliti Caprino Mirko, Loli Paola, Giustina Andrea
Department of Biological and Clinical Sciences, University of Turin, Turin, Italy.
Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy.
J Endocrinol Invest. 2025 Apr;48(Suppl 1):23-31. doi: 10.1007/s40618-024-02450-y. Epub 2024 Oct 3.
Skeletal comorbidities are frequent and clinically relevant findings in Cushing's syndrome (CS) since an uncoupled suppressed bone formation and enhanced bone resorption leads to a marked skeletal damage with a rapid increase of fracture risk. Reduced Bone Mineral Density (BMD) has been consistently reported and osteopenia or osteoporosis are typical findings in patients with CS. Vertebral Fractures (VFs) are frequently reported and may occur even in patients with an only mild reduction of BMD. Since CS is diagnosed late due to often difficult biochemical and radiological confirmation as well as to signs and symptoms common in other much more frequent diseases an approach suggested for overcoming underdiagnosis is to screen patients with manifestations which may overlap with those of CS such as arterial hypertension, diabetes mellitus and osteoporosis. Our review will focus on the rationale and best practice for screening osteoporotic patients for CS.
骨骼合并症在库欣综合征（CS）中很常见且具有临床相关性，因为骨形成受抑制和骨吸收增强的失衡会导致明显的骨骼损伤，骨折风险迅速增加。骨矿物质密度（BMD）降低一直有报道，骨质减少或骨质疏松是CS患者的典型表现。椎体骨折（VFs）经常有报道，甚至在BMD仅轻度降低的患者中也可能发生。由于CS往往因生化和放射学确诊困难以及其他更常见疾病的常见体征和症状而诊断较晚，因此建议采用的一种克服诊断不足的方法是对有与CS可能重叠表现的患者进行筛查，如动脉高血压、糖尿病和骨质疏松症。我们的综述将重点关注筛查骨质疏松症患者是否患有CS的基本原理和最佳实践。
