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Osteoporosis and osteopenia (OS\/OP) are frequent in patients with adrenal adenomas associated with cortisol excess (CE). However, the relationship between OS\/OP and CE severity considering sex differences is unknown. Design. A cross-sectional observational study from January 2006 to December 2015. Patients. 237 patients with adrenal adenoma associated with CE, including Cushing\u2019s syndrome and mild autonomous cortisol secretion (MACS), diagnosed in 10 referral centers in Japan. MACS was defined by 1\u2009mg overnight dexamethasone suppression test (DST) cortisol level &gt;1.8\u2009\u03bcg\/dL. Measurements. Prevalence of fragility fractures, medication for osteoporosis, and bone mineral density. Results. In total, 112 of 237 patients, who were predominantly female (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>) and had lower BMI (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.013<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), had OS\/OP. Patients with OS\/OP was significantly affected by CE (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>&lt;<\/e:mo>\n                        <e:mn>0.01<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>) than those without. The adjusted odds ratio (OR) for predicting OS\/OP was obtained in multivariate logistic regression analysis. Clinical measures of CE, 1\u2009mg DST cortisol levels, were positively associated with OS\/OP in total cases (OR 1.124, 95% CI: 1.070\u20131.181, <jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>&lt;<\/g:mo>\n                        <g:mn>0.001<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>) and the cases with MACS (OR 1.156, 95%CI: 1.046\u20131.278, <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>P<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.005<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>). A cutoff value of 1\u2009mg DST cortisol level &gt;5.0\u2009\u03bcg\/dL was associated with OS\/OP differently between men and women. OS\/OP risk in men with MACS was significantly affected only by 1\u2009mg DST cortisol levels. However, OS\/OP risk in women with MACS was significantly affected by 1\u2009mg DST cortisol levels and age. Conclusions. CE severity in adrenal adenoma is positively associated with OS\/OP. However, the associated factors of OS\/OP in the patients with MACS are different between men and women.<\/jats:p>","DOI":"10.1155\/2022\/5009395","type":"journal-article","created":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T00:20:09Z","timestamp":1647649209000},"page":"1-9","source":"Crossref","is-referenced-by-count":8,"title":["Sex Difference in the Association of Osteoporosis and Osteopenia Prevalence in Patients with Adrenal Adenoma and Different Degrees of Cortisol Excess"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2571-2875","authenticated-orcid":true,"given":"Shoichiro","family":"Izawa","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1566-7321","authenticated-orcid":true,"given":"Kazuhisa","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8187-6765","authenticated-orcid":true,"given":"Kazuhiko","family":"Matsuzawa","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuyuki","family":"Katabami","sequence":"additional","affiliation":[{"name":"Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanobu","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-8621","authenticated-orcid":true,"given":"Michio","family":"Otsuki","sequence":"additional","affiliation":[{"name":"Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan"},{"name":"Department of Endocrinology, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0757-7529","authenticated-orcid":true,"given":"Masakatsu","family":"Sone","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Nutrition, Kyoto University, Kyoto, Japan"},{"name":"Division of Metabolism and 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