{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:22:03Z","timestamp":1790691723113,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Endogenous Cushing's syndrome (CS) is a known cause of secondary osteoporosis. Vertebral fractures (VFs) in endogenous CS may occur despite normal bone mineral density (BMD). Trabecular bone score (TBS) is a relatively new, non\u2010invasive technique to assess bone microarchitecture. The objective of our study was to analyse the BMD and bone microarchitecture using TBS in endogenous CS and compare it with a group of age and sex\u2010matched healthy controls, and also analyse the factors predicting BMD and TBS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional study of cases and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and measurements<\/jats:title><jats:p>We included 40 female patients with overt endogenous CS, out of which 32 were adrenocorticotropic hormone (ACTH)\u2010dependent CS and 8 were ACTH\u2010independent. We also included 40 healthy, female controls. Both patients and controls were subjected to an assessment of biochemical parameters and BMD and TBS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with endogenous CS had significantly lower BMD at the lumbar spine, femoral neck, and total hip and significantly lower TBS than healthy controls (all <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), while no significant difference was noted in the distal radius BMD (<jats:italic>p<\/jats:italic>\u2009=\u2009.055). In endogenous CS, a large proportion of patients, <jats:italic>n<\/jats:italic>\u2009=\u200913 (32.5%) had normal BMD for age (BMD <jats:italic>Z<\/jats:italic>\u2010score\u2009\u2265\u2009\u22122.0) with low TBS (L<jats:sub>1<\/jats:sub>\u2010L<jats:sub>4<\/jats:sub> TBS\u2009\u2264\u20091.34). TBS correlated negatively with HbA1c (<jats:italic>p<\/jats:italic>\u2009=\u2009.006), and positively with serum T4 (<jats:italic>p<\/jats:italic>\u2009=\u2009.027).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TBS should be considered an important complementary tool in addition to BMD for the routine assessment of skeletal health in CS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14944","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T09:01:15Z","timestamp":1688461275000},"page":"253-261","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Trabecular bone score and bone mineral density as indices of skeletal fragility in endogenous Cushing's syndrome"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7868-8026","authenticated-orcid":false,"given":"Hiya","family":"Boro","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism All India Institute of Medical Sciences (AIIMS) New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Velmurugan","family":"Mannar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism All India Institute of Medical Sciences (AIIMS) New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5173-9193","authenticated-orcid":false,"given":"Rakhi","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism All India Institute of Medical Sciences (AIIMS) New Delhi 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