Relationship between subclinical hypercortisolism and osteoporosis: A systematic review and meta-analysis / 中华内分泌代谢杂志

ABSTRACT

Objective To explore the relationship between subclinical hypercortisolism (SH) and osteoprosis.Methods MEDLINE,BIOSIS Previews,High Wire Wanfang Database,and Vip Database were retrieved for articles about the relations of SH and osteoporosis.Searches were limited to Chinese/English-language publications.The clinical outcomes evaluated in this study included bone mineral density,biochemical markers of bone turnover,prevalence of osteoporosis,and incidence of fracture.Meta-analysis was carried out by RevMan5 among articles suitable for the inclusion and exclusion criteria.Results Fifteen studies were included,containing 6retrospective studies,6 prospective studies,and 3 intervention studies.Retrospective studies suggested that bone mineral density level in subclinical hypercortisolism group (SH + group) was significantly lower than that in the nonsubclinical hypercortisolism group (SH-group),meta-analysis of prospective studies showed that the level of bone mineral density at lumbar spine and femoral neck was significantly lower in SH+ group than that in the SH-group(all P＜0.01).Both retrospective studies and prospective studies showed no significant difference between the biochemical markers of bone turnover in both SH+ and SH-groups.Data from intervention studies showed that the prognosis in SH patients with surgical intervention was not improved.Conclusions SH reduces bone mineral density at lumbar spine and femoral neck,and increases the prevalence of osteoporosis and incidence of fracture.Whether surgical intervention is beneficial in SH patients remains uncertain.