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

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

J Clin Endocrinol Metab. 2017 Apr 04;:

Authors: Gonzalez Rodriguez E, Lamy O, Stoll D, Metzger M, Preisig M, Kuehner C, Vollenweider P, Marques-Vidal P, Waeber G, Aubry-Rozier B, Hans D

Abstract
Context: Increased evening cortisol levels, observed with aging and psychological stress, 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), a texture parameter correlated with bone microarchitecture, 2) fracture prevalence.
Design, Setting, Patients, and Interventions: Cross-sectional study including 608 women >50 years old (mean 65.5) from OsteoLaus cohort. Data included: FRAX© questionnaire, BMD, TBS and vertebral fracture (VFx) assessment by dual X-ray absorptiometry, and measures of salivary cortisol circadian rhythm (awakening, 30 minutes thereafter, 11 AM and 8 PM).
Results: In the multivariate model, participants in the highest tertile of 8PM salivary cortisol (sc-8PM) (mean 5.7±2.5 nmol/l) versus 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 (OR 5.34; p=0.012), low-trauma fractures (OR 1.80; p=0.036) and major osteoporotic fractures (OR 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-8PM and TBS independently of each other, and of all other risk factors. The cut point for sc-8PM correlating with the presence of >1 VFx was 3.62 nmol/l (sensitivity 0.74, specificity 0.66).
Conclusions: High sc-8PM is associated with low TBS and an increased prevalence of radiologic VFx independently of other risk factors. Measurement of salivary cortisol at 8PM may add relevant information in the assessment of fracture risk.

PMID: 28379565 [PubMed - as supplied by publisher]

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