High evening cortisol level is associated with low TBS and increased prevalent vertebral fractures: OsteoLaus study
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 (...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
1 July 2017
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| In: |
The journal of clinical endocrinology & metabolism
Year: 2017, Volume: 102, Issue: 7, Pages: 2628-2636 |
| ISSN: | 1945-7197 |
| DOI: | 10.1210/jc.2016-3804 |
| Online Access: | Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1210/jc.2016-3804 Verlag, kostenfrei, Volltext: https://academic-oup-com.ezproxy.medma.uni-heidelberg.de/jcem/article/102/7/2628/3100442 
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| Author Notes: | 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 |
| Summary: | 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. |
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| Item Description: | First published online 4 April 2017 Gesehen am 12.06.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1945-7197 |
| DOI: | 10.1210/jc.2016-3804 |