TABLE 1:
Demographic data and bone turnover marker levels of patients with adrenal adenomas
| CS (n=22) | MACS (n=92) | NFAT (n=99) | P-value (CS vs MACS vs NFAT) | P-value (MACS vs NFAT) | |
|---|---|---|---|---|---|
| Demographics | |||||
| Age, median (range), years | 41.5 (18–61) | 59.5 (28–82) | 59 (28–93) | <0.0001 | 0.664 |
| Female, n (%) | 18 (86%) | 57 (62%) | 67 (68%) | 0.456 | 0.41 |
| BMI median (range), kg/m2 | 30.1 (21.9 – 54.6) | 31 (17 – 53) | 31 (15 – 51) | 0.06 | 0.525 |
| Weight, median (range), kg | 84 (62–113) | 89 (62–128) | 90 (63–126) | 0.29 | 0.94 |
| Computed tomography imaging | |||||
| Tumor size, median (range),cm | 3 (0.5–6.1) | 3.1 (0.5–14.4) | 1.7 (3–4.5) | <0.0001 | <0.001 |
| Unenhanced CT attenuation, n, median (range) Hounsfield units, n =151 |
n=13 10 (−55 to 36) |
n=68 8.25 (−20 to 36) |
n=70 7 (−27 to 41) |
0.416 | 0.32 |
| Endocrine work up | |||||
| Cortisol after overnight 1 mg dexamethasone, median, nmol/L (range), μg/dL (range) |
235 (61–689) 8.5 (2.2–25) |
83 (52–441) 3 (1.9–16) |
33 (25–49) 1.2 (0.9–1.8) |
<0.0001 | <0.001 |
| ACTH, n, median, pmol/L (range), pg/mL (range n=162 |
n=18 1.1 (1.09–2.94) 5 (4.99–13.4) |
n=78 1.97( 1.1–6.2) 8.95 (5–28.2) |
n=66 3.41 (2.0–6.16) 15.5 (9.27– 28) |
<0.0001 | <0.0001 |
| Urine cortisol, n, median μg/dL/24h (range) nmol/24h (range) n=156 |
n=21 108 (25–875) 298 (69–2415) |
n=74 26(2.6–84) 72(7.2–232) |
n=61 22(3.4–71) 61(9.4–196) |
<0.0001 | 0.049 |
| DHEA-S index, n, median (range), n =146 |
n=19 0.65 (0.18–7.03) |
n=71 2.63 (0.11–17.2) |
n=56 4.63 (0.58–16.41) |
<0.0001 | 0.007 |
| Cardiovascular Risk Factors | |||||
| Hypertension, n (%) | 16(73%) | 66(73%) | 63(64%) | 0.36 | 0.17 |
| Dyslipidemia, n (%) | 7(32%) | 57(63%) | 53(54%) | 0.03 | 0.18 |
| Diabetes Mellitus/IFG, n (%) | 9(41%) | 38(41%) | 40(41%) | 0.99 | 0.98 |
| Bone Disease | |||||
| DXA Bone density scans performed, n (%) | 8 (37%) | 48 (52%) | 31 (31%) | ||
| Osteopenia, n (%) | 5 (62%) | 27 (56%) | 16 (52%) | 0.84 | 0.69 |
| Osteoporosis, n (%) | 3 (38%) | 10 (21%) | 6 (19%) | 0.56 | 0.87 |
| Osteopenia and osteoporosis, n (%) | 8 (100%) | 37 (77%) | 22 (71%) | 0.09 | 0.54 |
| Bone Turnover Markers | |||||
| Osteocalcin, mean (SD), (range), ng/mL | 14.8 (16.3) (2.2–79.6) |
20.1 (10.2) (5.4–53.7) |
21.3 (12.1) (2.2–78.8) |
<0.0001 | 0.39 |
| PINP, mean (SD), (range), μg/L | 34.8 (23.6) (12.3–91.6) |
48.7 (23.5) (13.3–123) |
48.5 (22) (3–152) |
0.003 | 0.84 |
| CTX, mean (SD), (range), ng/mL | 0.3 (0.2) (0.09–0.93) |
0.4 (0.3) (0.05–1.28) |
0.4 (0.2) (0.10–1.16) |
0.15 | 0.5 |
| Sclerostin, mean (SD), (range), pg/mL | 419 (199) (73.2–683) |
538 (296) (111–873) |
624 (218) (202–1273) |
<0.0001 | 0.005 |
All P-values < 0.05 were considered statistically significant.
CS: Cushing syndrome; MACS: Mild autonomous cortisol secretion; NFAT: non-functioning adrenal tumors; BMI: body mass index; CT : computed-tomography; ACTH : Adrenocorticotrophic hormone; DHEA-S: dehydroepiandrosterone sulfate, IFG: impaired fasting glucose; DXA: Dual-energy X-ray absorptiometry, PINP: N-terminal propeptide of type 1 collagen; CTX: C-terminal telopeptide of Type 1 collagen; SD: standard deviation