High evening cortisol level is associated with low TBS and increased prevalent vertebral fractures

• Verfasst von: Gonzalez Rodriguez, Elena [VerfasserIn]
• Verfasst von: Kühner, Christine [VerfasserIn]
• Titel: High evening cortisol level is associated with low TBS and increased prevalent vertebral fractures
• Titelzusatz: OsteoLaus study
• Verf.angabe: Elena Gonzalez Rodriguez, Olivier Lamy, Delphine Stoll, Marie Metzger, Martin Preisig, Christine Kuehner, Peter Vollenweider, Pedro Marques-Vidal, Gérard Waeber, Bérengère Aubry-Rozier, and Didier Hans
• E-Jahr: 2017
• Jahr: 1 July 2017
• Umfang: 9 S.
• Fussnoten: First published online 4 April 2017 ; Gesehen am 12.06.2018
• Titel Quelle: Enthalten in: The journal of clinical endocrinology & metabolism
• Ort Quelle: Oxford : Oxford University Press, 1941
• Jahr Quelle: 2017
• Band/Heft Quelle: 102(2017), 7, Seite 2628-2636
• ISSN Quelle: 1945-7197
• DOI: doi:10.1210/jc.2016-3804
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1576272516

Abstract

Context: Increased evening cortisol levels have been implicated in bone mineral density (BMD) loss. The effect on bone microarchitecture and fracture risk has never been studied. Objective: To study the relationship between salivary cortisol circadian rhythm and (1) trabecular bone score (TBS) and (2) fracture prevalence. Design, Setting, Patients, and Interventions: Cross-sectional study including 608 women >50 years old (mean = 65.5) from the OsteoLaus cohort. Data included the FRAX© questionnaire, BMD, TBS and vertebral fracture (VFx) assessment by dual X-ray absorptiometry, and measures of salivary cortisol (awakening, 30 minutes thereafter, 11 am, and 8 pm). Results: In the multivariate model, participants in the highest tertile of 8 pm salivary cortisol (sc-8 pm) (mean = 5.7 ± 2.5 nmol/L) vs lowest tertile (1.7 ± 0.4 nmol/L) had lower TBS values (1.27 vs 1.29; P = 0.02), more prevalent VFx grades 2 and 3 (odds ratio = 5.34; P = 0.012), low-trauma fractures (odds ratio = 1.80; P = 0.036), and major osteoporotic fractures (odds ratio = 1.96; P = 0.042), without difference in lumbar spine BMD (0.91 vs 0.92 g/cm2; P = 0.431). VFx prevalence was associated with sc-8 pm and TBS independently of each other and of other risk factors. The cut-point for sc-8 pm correlating with the presence of >1 VFx was 3.62 nmol/L (sensitivity 0.74, specificity 0.66). Conclusions: High sc-8 pm is associated with low TBS and an increased prevalence of radiologic VFx independently of other risk factors. Measurement of sc-8 pm may add relevant information in the assessment of fracture risk.