title: Subclinical hypercortisol-assessment of bone fragility: experience of single osteoporosis center in Sicily.
abstract: OBJECTIVE
  Hypercortisolism is known to cause osteoporosis. Some evidence suggests that osteoporotic fractures may be the presenting manifestations of otherwise-asymptomatic hypercortisolism. The aim of our research was to investigate the prevalence of subclinical hypercortisolism (SH) in postmenopausal women evaluated for bone fragility.
  
  
  METHODS
  One hundred consecutive postmenopausal women attending the Osteoporosis Centre in the Department of Internal Medicine of the University of Messina (Messina, Italy), for the first time, were screened and a total of 50 patients (age 58±5 years) were studied. Hypercortisolism was diagnosed by unsuppressed serum cortisol levels after 2 day low dose dexamethasone suppression test.
  
  
  RESULTS
  Among the 50 postmenopausal women studied, 3 had SH. This prevalence was 6%. The three patients with SH had a normal bone mineral density (BMD) at lumbar spine and were osteopenic at femoral neck, and presented one or more vertebral fractures at spinal radiography.
  
  
  CONCLUSIONS
  Physicians should always consider SH among the causes of bone fragility, especially in individuals with vertebral fractures and the presence of an only slightly reduced BMD.
authors.affiliation: Department of Internal Medicine, University of Messina, Italy. matteritano@unime.it.
authors.forename: A
authors.initials: A
authors.lastname: Lasco
authors.forename: A
authors.initials: A
authors.lastname: Catalano
authors.forename: A
authors.initials: A
authors.lastname: Pilato
authors.forename: G
authors.initials: G
authors.lastname: Basile
authors.forename: A
authors.initials: A
authors.lastname: Mallamace
authors.forename: M
authors.initials: M
authors.lastname: Atteritano
mesh_terms: D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000378:metabolism; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D003480:Cushing Syndrome / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D005260:Female; D050723:Fractures, Bone / Q000097:blood / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000652:urine; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011859:Radiography; D012802:Sicily; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D006854:Hydrocortisone