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British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1987 Mar 28;294(6575):798–800. doi: 10.1136/bmj.294.6575.798

Bone mineral density in Addison's disease: evidence for an effect of adrenal androgens on bone mass.

J P Devogelaer, J Crabbé, C Nagant de Deuxchaisnes
PMCID: PMC1245862  PMID: 2952217

Abstract

It is unknown whether replacement doses of cortisone acetate and the absence of the small amounts of androgens secreted by the adrenal cortex may cause osteoporosis. This was studied in 35 patients (12 men and 23 women) suffering from primary adrenocortical failure and taking cortisone acetate 25-37.5 mg and fludrocortisone 50-100 micrograms daily. Bone mineral density was measured by single photon absorptiometry at the midshaft of the radius, representing cortical bone, and at the distal part of the radius, a site with a significant trabecular component. The bone mineral density was normal in premenopausal female patients as well as in male patients, showing that replacement doses of cortisone acetate do not affect bone mass. By contrast, in postmenopausal patients there was a dramatic bone loss in addition to the physiological postmenopausal decrease in bone mass. This loss, combined with the low plasma concentrations of androstenedione, dehydroepiandrosterone, and testosterone (and low concentrations of oestrone of adrenal origin), indicates that adrenal androgens may be essential for the maintenance of bone mass in postmenopausal women with Addison's disease. In addition, these data indicate that the small amounts of androgens secreted by the adrenal cortex have a role in the maintenance of bone mass in normal postmenopausal women.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Frisch R. E., Canick J. A., Tulchinsky D. Human fatty marrow aromatizes androgen to estrogen. J Clin Endocrinol Metab. 1980 Aug;51(2):394–396. doi: 10.1210/jcem-51-2-394. [DOI] [PubMed] [Google Scholar]
  2. Good A. E., Green R. A., Zarafonetis C. J. Rheumatic symptoms during tuberculosis therapy. A manifestation of isoniazid toxicity? Ann Intern Med. 1965 Nov;63(5):800–807. doi: 10.7326/0003-4819-63-5-800. [DOI] [PubMed] [Google Scholar]
  3. Levin M. E., Boisseau V. C., Avioli L. V. Effects of diabetes mellitus on bone mass in juvenile and adult-onset diabetes. N Engl J Med. 1976 Jan 29;294(5):241–245. doi: 10.1056/NEJM197601292940502. [DOI] [PubMed] [Google Scholar]
  4. Longcope C. Adrenal and gonadal androgen secretion in normal females. Clin Endocrinol Metab. 1986 May;15(2):213–228. doi: 10.1016/s0300-595x(86)80021-4. [DOI] [PubMed] [Google Scholar]
  5. Marshall D. H., Crilly R. G., Nordin B. E. Plasma androstenedione and oestrone levels in normal and osteoporotic postmenopausal women. Br Med J. 1977 Nov 5;2(6096):1177–1179. doi: 10.1136/bmj.2.6096.1177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Nordin B. E., Robertson A., Seamark R. F., Bridges A., Philcox J. C., Need A. G., Horowitz M., Morris H. A., Deam S. The relation between calcium absorption, serum dehydroepiandrosterone, and vertebral mineral density in postmenopausal women. J Clin Endocrinol Metab. 1985 Apr;60(4):651–657. doi: 10.1210/jcem-60-4-651. [DOI] [PubMed] [Google Scholar]
  7. Seeman E., Wahner H. W., Offord K. P., Kumar R., Johnson W. J., Riggs B. L. Differential effects of endocrine dysfunction on the axial and the appendicular skeleton. J Clin Invest. 1982 Jun;69(6):1302–1309. doi: 10.1172/JCI110570. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Vermeulen A., Verdonck L. Sex hormone concentrations in post-menopausal women. Clin Endocrinol (Oxf) 1978 Jul;9(1):59–66. doi: 10.1111/j.1365-2265.1978.tb03572.x. [DOI] [PubMed] [Google Scholar]
  9. Wahner H. W., Riggs B. L., Beabout J. W. Diagnosis of osteoporosis: usefulness of photon absorptiometry at the radius. J Nucl Med. 1977 May;18(5):432–437. [PubMed] [Google Scholar]
  10. de Deuxchaisnes C. N., Devogelaer J. P., Esselinckx W., Bouchez B., Depresseux G., Rombouts-Lindemans C., Huaux J. P. The effect of low dosage glucocorticoids on bone mass in rheumatoid arthritis: a cross-sectional and a longitudinal study using single photon absorptiometry. Adv Exp Med Biol. 1984;171:209–239. [PubMed] [Google Scholar]
  11. de Hertogh R. Radioimmunoassay of estrone and estradiol-17 in peripheral plasma of pregnant and non-pregnant women. J Steroid Biochem. 1973 Jan;4(1):75–84. doi: 10.1016/0022-4731(73)90082-4. [DOI] [PubMed] [Google Scholar]

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