Association of IGF-1 Level with Low Bone Mass in Young Patients with Cushing's Disease.

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM International Journal of Endocrinology Pub Date : 2023-01-01 DOI:10.1155/2023/3334982

Wanwan Sun, Quanya Sun, Qiaoli Cui, Min He, Wei Wu, Yiming Li, Hongying Ye, Shuo Zhang

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Abstract

Purpose: Few related factors of low bone mass in Cushing's disease (CD) have been identified so far, and relevant sufficient powered studies in CD patients are rare. On account of the scarcity of data, we performed a well-powered study to identify related factors associated with low bone mass in young CD patients.

Methods: This retrospective study included 153 CD patients (33 males and 120 females, under the age of 50 for men and premenopausal women). Bone mineral density (BMD) of the left hip and lumbar spine was measured by dual energy X-ray absorptiometry (DEXA). In this study, low bone mass was defined when the Z score was -2.0 or lower.

Results: Among those CD patients, low bone mass occurred in 74 patients (48.37%). Compared to patients with normal BMD, those patients with low bone mass had a higher level of serum cortisol at midnight (22.31 (17.95-29.62) vs. 17.80 (13.75-22.77), p=0.0006), testosterone in women (2.10 (1.33-2.89) vs. 1.54 (0.97-2.05), p=0.0012), higher portion of male (32.43% vs. 11.54%, p=0.0016) as well as hypertension (76.12% vs. 51.67%, p=0.0075), and lower IGF-1 index (0.59 (0.43-0.76) vs. 0.79 (0.60-1.02), p=0.0001). The Z score was positively associated with the IGF-1 index in both the lumbar spine (r = 0.35153, p < 0.0001) and the femoral neck (r = 0.24418, p=0.0057). The Z score in the femoral neck was negatively associated with osteocalcin (r = -0.22744, p=0.0229). Compared to the lowest tertile of the IGF-1 index (<0.5563), the patients with the highest tertile of the IGF-1 index (≥0.7993) had a lower prevalence of low bone mass (95% CI 0.02 (0.001-0.50), p=0.0002), even after adjusting for confounders such as age, gender, duration, BMI, hypertension, serum cortisol at midnight, PTH, and osteocalcin.

Conclusions: The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.

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年轻库欣病患者IGF-1水平与低骨量的关系

目的:库欣病(Cushing's disease, CD)低骨量的相关因素目前尚不明确，在CD患者中进行的相关研究也很少。由于缺乏数据，我们进行了一项强有力的研究，以确定与年轻乳糜泻患者低骨量相关的相关因素。方法:本回顾性研究纳入153例CD患者(男性33例，女性120例，年龄在50岁以下的男性和绝经前女性)。采用双能x线骨密度仪(DEXA)测量左髋关节和腰椎骨密度(BMD)。在本研究中，当Z评分为-2.0或更低时，定义为低骨量。结果:CD患者中低骨量74例(48.37%)。与骨密度正常患者相比，低骨量患者午夜血清皮质醇水平(22.31(17.95-29.62)比17.80 (13.75-22.77)，p=0.0006)，女性睾酮水平(2.10(1.33-2.89)比1.54 (0.97-2.05)，p=0.0012)，男性较高(32.43%比11.54%，p=0.0016)，高血压(76.12%比51.67%，p=0.0075)， IGF-1指数较低(0.59(0.43-0.76)比0.79 (0.60-1.02)，p=0.0001)。Z评分与腰椎(r = 0.35153, p < 0.0001)和股骨颈(r = 0.24418, p=0.0057) IGF-1指数呈正相关。股骨颈Z评分与骨钙素呈负相关(r = -0.22744, p=0.0229)。与IGF-1指数的最低分位数相比(p=0.0002)，即使在调整了混杂因素如年龄、性别、病程、BMI、高血压、午夜血清皮质醇、PTH和骨钙素之后。结论:IGF-1指数高与年轻CD低骨量发生率低独立相关，IGF-1可能在CD低骨量发病机制中发挥重要作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Endocrinology ENDOCRINOLOGY & METABOLISM-

CiteScore

5.20

自引率

0.00%

发文量

147

审稿时长

1 months

期刊介绍： International Journal of Endocrinology is a peer-reviewed, Open Access journal that provides a forum for scientists and clinicians working in basic and translational research. The journal publishes original research articles, review articles, and clinical studies that provide insights into the endocrine system and its associated diseases at a genomic, molecular, biochemical and cellular level.