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Subclinical Hypercortisolism among Outpatients Referred for Osteoporosis

Iacopo Chiodini, MD; Maria Lucia Mascia, MD; Silvana Muscarella, MD; Claudia Battista, MD; Salvatore Minisola, MD; Maura Arosio, MD; Stefano Angelo Santini, MD; Giuseppe Guglielmi, MD; Vincenzo Carnevale, MD; and Alfredo Scillitani, MD
[+] Article and Author Information

From “San Giuseppe-Fatebenefratelli” Hospital, Fatebenefratelli Research Association, University of Milan, Fondazione Policlinico, Mangiagalli e Regina Elena, Scientific Institute, Milan, Italy; “Casa Sollievo della Sofferenza” Scientific Institute, San Giovanni Rotondo, Foggia, Italy; and University “La Sapienza,” Rome, Italy.


Potential Financial Conflicts of Interest: None disclosed.

Reproducible Research Statement:Study protocol and data set: Available to readers upon request. Statistical code: Not available.

Requests for Single Reprints: Alfredo Scillitani, MD, Unit of Endocrinology, “Casa Sollievo della Sofferenza” Scientific Institute, Viale dei Cappuccini, San Giovanni Rotondo, 71013, Foggia, Italy; e-mail, alscill@tin.it.

Current Author Addresses: Drs. Chiodini and Arosio: Department of Medical Sciences, University of Milan, Fondazione Policlinico, Mangiagalli e Regina Elena, Scientific Institute, Via F. Sforza 35, 20122, Milan, Italy.

Drs. Mascia, Muscarella, Battista, and Scillitani: Unit of Endocrinology, “Casa Sollievo della Sofferenza” Scientific Institute, Viale dei Cappuccini, 71013, San Giovanni Rotondo, Foggia, Italy.

Dr. Minisola: Department of Clinical Sciences, University “La Sapienza,” Rome, Italy.

Dr. Santini: Department of Clinical Chemistry, “Casa Sollievo della Sofferenza” Scientific Institute, Viale dei Cappuccini, 71013, San Giovanni Rotondo, Foggia, Italy.

Dr. Guglielmi: Department of Radiology, “Casa Sollievo della Sofferenza” Scientific Institute, Viale dei Cappuccini, 71013, San Giovanni Rotondo, Foggia, Italy.

Dr. Carnevale: Department of Internal Medicine, “Casa Sollievo della Sofferenza” Scientific Institute, Viale dei Cappuccini, 71013, San Giovanni Rotondo, Foggia, Italy.

Author Contributions: Analysis and interpretation of the data: I. Chiodini, M.L. Mascia, S. Muscarella, C. Battista, S. Minisola, M. Arosio, S.A. Santini, G. Guglielmi, V. Carnevale, A. Scillitani.

Drafting of the article: I. Chiodini, A. Scillitani.

Critical revision of the article for important intellectual content: S. Minisola, M. Arosio, G. Guglielmi, V. Carnevale, A. Scillitani.

Final approval of the article: I. Chiodini, S. Muscarella, C. Battista, S. Minisola, M. Arosio, G. Guglielmi, V. Carnevale, A. Scillitani, M.L. Mascia, S.A. Santini.

Statistical expertise: A. Scillitani.

Collection and assembly of data: I. Chiodini, M.L. Mascia, S. Muscarella, C. Battista, S.A. Santini, A. Scillitani.


Ann Intern Med. 2007;147(8):541-548. doi:10.7326/0003-4819-147-8-200710160-00006
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Table 1 reports patient characteristics. In an evaluation for secondary causes of osteoporosis, no patient had celiac or thyroid disease, 1 male patient (0.5%) with osteoporosis had hypogonadism, and 3 female patients (1.3%) had primary hyperparathyroidism. One hundred thirty-six patients (62.1%) had a BMD T-score less than −2.5, and 76 patients (34.7%) had vertebral fractures. All vertebral fractures were asymptomatic and were not clinically evident before testing.

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Grahic Jump Location
Figure.
Study flow diagram.

All patients were subdivided on the basis of bone mineral density (BMD) (T-score of −2.5 or less [low BMD] or greater than −2.5 [normal BMD]) and vertebral fractures. ACTH = adrenocorticotropic hormone; Fx+ = presence of vertebral fractures; Fx− = absence of vertebral fractures.

Grahic Jump Location

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Summary for Patients

How Common Are High Cortisol Levels in Apparently Healthy People with Osteoporosis?

The summary below is from the full report titled “Subclinical Hypercortisolism among Outpatients Referred for Osteoporosis.” It is in the 16 October 2007 issue of Annals of Internal Medicine (volume 147, pages 541-548). The authors are I. Chiodini, M.L. Mascia, S. Muscarella, C. Battista, S. Minisola, M. Arosio, S.A. Santini, G. Guglielmi, V. Carnevale, and A. Scillitani.

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