{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T18:15:08Z","timestamp":1780337708090,"version":"3.54.1"},"reference-count":29,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health - Ricerca Corrente","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Mild autonomous cortisol secretion (MACS) is associated with increased risk of vertebral fractures (VFx).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim was to investigate impact of recovery from MACS on bone health remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective intervention study (Study 1): 53 patients with MACS were followed for 35.2 \u00b1 18.6 months; 31 patients underwent surgery (Study 1-Group A, 74.2% women, age 63 years [57-67]), while 22 patients received conservative treatment (Study 1-Group B, 45.5% women, age 64 years [61-72]). Prospective randomized study (Study 2): Fifty-one outpatients with MACS were randomly assigned to either adrenalectomy (Study 2-Group A, 21 patients, 67% women, age 63 [56.5-72.5]) or conservative approach (Study 2-Group B, 28 patients, 78% women, age 69 [61-73]) and were followed for 24 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MACS was diagnosed in patients with adrenal incidentalomas (AIs) &amp;gt;1\u2005cm and cortisol after the 1-mg dexamethasone suppression test \u22651.8\u2005\u00b5g\/dL (50\u2005nmol\/L). At baseline and at the end of follow-up we assessed calcium\u2013phosphorus metabolism, bone mineral density (BMD) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) using dual-energy X-ray absorptiometry, and the presence of VFx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Study 1: At the end of the follow-up, Study 1-Group B showed an increased incidence of VFx (n = 11, 50%) than Study 1-Group A (n = 3, 9.7%, P &amp;lt; .005). In both groups, BMD at LS, FN, and TH was comparable between baseline and the end of follow-up. Study 2: After 24 months in Study 2-Group A, but not in Study 2-Group B, calcium and phosphorus levels increased compared with baseline (P = .03 and P = .04, respectively). At the end of follow-up, BMD remained stable across both groups, but Study 2-Group B showed a significantly higher incidence of VFx (n = 7, 25%) than Study 2-Group A (n = 1, 4.8%, P = .04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with AI and MACS, adrenalectomy significantly reduces the risk of VFx.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf227","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T09:01:30Z","timestamp":1744102890000},"page":"e4066-e4074","source":"Crossref","is-referenced-by-count":10,"title":["Adrenalectomy Reduces the Risk of Vertebral Fractures in Patients With Mild Autonomous Cortisol Secretion"],"prefix":"10.1210","volume":"110","author":[{"given":"Valentina","family":"Morelli","sequence":"first","affiliation":[{"name":"Endocrinology Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano , 20149 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Favero","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnology and Translational Medicine, University of Milan , 20122 Milan ,","place":["Italy"]},{"name":"Unit of Endocrinology, ASST Grande Ospedale Metropolitano Niguarda , 20163 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Frigerio","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Fondazione IRCCS C\u00e0 Granda-Ospedale Maggiore Policlinico, 20122 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Aresta","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, ASST Grande Ospedale Metropolitano Niguarda , 20163 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, \u201cCasa Sollievo della Sofferenza Hospital\u201d IRCCS , 71013 San Giovanni Rotondo, Foggia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Stefano","family":"Salcuni","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology and Metabolism, University-Hospital S. 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