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Risk Factors for Osteoporotic Vertebral Fracture in Cushing Syndrome

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2017, 24(1), pp.1-6
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

Seung-Hwan Lee 1 Byeong-Mun Park 2 Kyung-Sub Song 1 Su-Keon Lee 1 윤상필 1 이재철 1 이범석 1 Bong-Seok Yang 1

1광명성애병원 정형외과
2광명 성애병원 정형외과

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ABSTRACT

Study design: Retrospective study. Objectives: The goal of this study was to evaluate the risk factors of osteoporotic vertebral fractures (OVFs) in patients with Cushing syndrome. Summary of Literature review: In most reports, vertebral fractures in Cushing syndrome have been found to be related to osteoporosis. However, few studies have analyzed the clinical risk factors for OVFs. Materials and Methods: Thirty-two patients with Cushing syndrome who visited the orthopaedic department complaining of back pain were included in this study. Standing lateral X-rays were performed to evaluate the presence of vertebral fractures, and bone mineral density (BMD) was measured. Results: Of the 32 patients with Cushing syndrome with back pain, 8 (25%) were diagnosed with OVFs using morphometric criteria. The average weight and body mass index of the vertebral fracture group (VF group) were significantly higher than the values observed in the non-vertebral fracture group (non-VF group) (p=0.004, p=0.018). Lumbar BMD was significantly lower in the VF group (p=0.006). A risk factor for OVFs in Cushing syndrome was osteoporosis (odds ratio=18.56, 95% confidence interval=1.72-200.21, p=0.016) regardless of gender, obesity, menopause, or urine free cortisol levels. Conclusions: OVFs in Cushing syndrome have been associated with overweight, and overweight is an indicator of compliance in the treatment of Cushing syndrome. Therefore, weight reduction and the prevention of osteoporosis should be emphasized in patients with Cushing syndrome to prevent OVFs.

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