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Hypertension 59: 592\u2013598.","DOI":"10.1161\/HYPERTENSIONAHA.111.186478"},{"key":"74","doi-asserted-by":"crossref","first-page":"e93136","DOI":"10.1172\/jci.insight.93136","volume":"2","author":"W Arlt","year":"2017","unstructured":"74 Arlt W, Lang K, Sitch AJ, Dietz AS, Rhayem Y, et al. (2017) Steroid metabolome analysis reveals prevalent glucocorticoid excess in primary aldosteronism. JCI Insight 2: e93136.","journal-title":"JCI Insight","ISSN":"https:\/\/id.crossref.org\/issn\/2379-3708","issn-type":"print"},{"key":"75","doi-asserted-by":"crossref","unstructured":"75 Yokomoto-Umakoshi M, Fujita M, Umakoshi H, Ogasawara T, Iwahashi N, et al. (2025) Multiomics analysis unveils the cellular ecosystem with clinical relevance in aldosterone-producing adenomas with KCNJ5 mutations. Proc Natl Acad Sci U S A 122: e2421489122.","DOI":"10.1073\/pnas.2421489122"},{"key":"76","doi-asserted-by":"publisher","unstructured":"76 Takeda S, Elefteriou F, Levasseur R, Liu X, Zhao L, et al. (2002) Leptin regulates bone formation <i>via<\/i> the sympathetic nervous system. Cell 111: 305\u2013317.","DOI":"10.1016\/S0092-8674(02)01049-8"},{"key":"77","doi-asserted-by":"publisher","unstructured":"77 Elefteriou F, Ahn JD, Takeda S, Starbuck M, Yang X, et al. (2005) Leptin regulation of bone resorption by the sympathetic nervous system and CART. Nature 434: 514\u2013520.","DOI":"10.1038\/nature03398"},{"key":"78","doi-asserted-by":"crossref","unstructured":"78 Kajimura D, Hinoi E, Ferron M, Kode A, Riley KJ, et al. (2011) Genetic determination of the cellular basis of the sympathetic regulation of bone mass accrual. J Exp Med 208: 841\u2013851.","DOI":"10.1084\/jem.20102608"},{"key":"79","doi-asserted-by":"crossref","unstructured":"79 Bonnet N, Laroche N, Vico L, Dolleans E, Benhamou CL, et al. (2006) Dose effects of propranolol on cancellous and cortical bone in ovariectomized adult rats. J Pharmacol Exp Ther 318: 1118\u20131127.","DOI":"10.1124\/jpet.106.105437"},{"key":"80","doi-asserted-by":"crossref","unstructured":"80 Kondo H, Togari A (2011) Continuous treatment with a low-dose \u03b2-agonist reduces bone mass by increasing bone resorption without suppressing bone formation. Calcif Tissue Int 88: 23\u201332.","DOI":"10.1007\/s00223-010-9421-9"},{"key":"81","doi-asserted-by":"crossref","unstructured":"81 Toulis KA, Hemming K, Stergianos S, Nirantharakumar K, Bilezikian JP (2014) \u03b2-adrenergic receptor antagonists and fracture risk: a meta-analysis of selectivity, gender, and site-specific effects. Osteoporos Int 25: 121\u2013129.","DOI":"10.1007\/s00198-013-2498-z"},{"key":"82","doi-asserted-by":"crossref","unstructured":"82 Khosla S, Drake MT, Volkman TL, Thicke BS, Achenbach SJ, et al. (2018) Sympathetic \u03b21-adrenergic signaling contributes to regulation of human bone metabolism. J Clin Invest 128: 4832\u20134842.","DOI":"10.1172\/JCI122151"},{"key":"83","doi-asserted-by":"crossref","unstructured":"83 Neumann HPH, Young WF Jr, Eng C (2019) Pheochromocytoma and paraganglioma. N Engl J Med 381: 552\u2013565.","DOI":"10.1056\/NEJMra1806651"},{"key":"84","doi-asserted-by":"crossref","unstructured":"84 Prejbisz A, Lenders JW, Eisenhofer G, Januszewicz A (2011) Cardiovascular manifestations of phaeochromocytoma. J Hypertens 29: 2049\u20132060.","DOI":"10.1097\/HJH.0b013e32834a4ce9"},{"key":"85","doi-asserted-by":"publisher","unstructured":"85 Yokomoto-Umakoshi M, Umakoshi H, Fukumoto T, Matsuda Y, Nagata H, et al. (2020) Pheochromocytoma and paraganglioma: an emerging cause of secondary osteoporosis. Bone 133: 115221.","DOI":"10.1016\/j.bone.2020.115221"},{"key":"86","doi-asserted-by":"crossref","unstructured":"86 Yokomoto-Umakoshi M, Umakoshi H, Ogata M, Fukumoto T, Matsuda Y, et al. (2020) Coexistence of osteoporosis and atherosclerosis in pheochromocytoma: new insights into its long-term management. Osteoporos Int 31: 2151\u20132160.","DOI":"10.1007\/s00198-020-05527-5"},{"key":"87","doi-asserted-by":"crossref","unstructured":"87 Veldhuis-Vlug AG, El Mahdiui M, Endert E, Heijboer AC, Fliers E, et al. (2012) Bone resorption is increased in pheochromocytoma patients and normalizes following adrenalectomy. J Clin Endocrinol Metab 97: E2093\u2013E2097.","DOI":"10.1210\/jc.2012-2823"},{"key":"88","doi-asserted-by":"crossref","unstructured":"88 Kim BJ, Kwak MK, Ahn SH, Kim H, Lee SH, et al. (2017) Lower bone mass and higher bone resorption in pheochromocytoma: importance of sympathetic activity on human bone. J Clin Endocrinol Metab 102: 2711\u20132718.","DOI":"10.1210\/jc.2017-00169"},{"key":"89","doi-asserted-by":"crossref","unstructured":"89 Dutta D, Nagendra L, Chandran M, Sharma M, Bhattacharya S, et al. (2024) Impact of pheochromocytoma or paraganglioma on bone metabolism: a systemic review and meta-analysis. J Clin Densitom 27: 101501.","DOI":"10.1016\/j.jocd.2024.101501"},{"key":"90","doi-asserted-by":"crossref","unstructured":"90 Kim BJ, Kwak MK, Kim JS, Lee SH, Koh JM (2018) Higher sympathetic activity as a risk factor for skeletal deterioration in pheochromocytoma. Bone 116: 1\u20137.","DOI":"10.1016\/j.bone.2018.06.023"},{"key":"91","doi-asserted-by":"crossref","unstructured":"91 Yokomoto-Umakoshi M, Umakoshi H, Sakamoto R, Fukumoto T, Ogata M, et al. (2021) Role of deteriorated bone quality in the development of osteoporosis in pheochromocytoma and paraganglioma. Bone 142: 115607.","DOI":"10.1016\/j.bone.2020.115607"},{"key":"92","doi-asserted-by":"crossref","unstructured":"92 Qi W, Cui L, Jiajue R, Pang Q, Chi Y, et al. (2024) Deteriorated bone microarchitecture caused by sympathetic overstimulation in pheochromocytoma and paraganglioma. J Endocrinol Invest 47: 843\u2013856.","DOI":"10.1007\/s40618-023-02198-x"},{"key":"93","doi-asserted-by":"crossref","unstructured":"93 Braun LT, Fazel J, Zopp S, Benedix S, Osswald-Kopp A, et al. (2020) The effect of biochemical remission on bone metabolism in Cushing\u2019s syndrome: a 2-year follow-up study. J Bone Miner Res 35: 1711\u20131717.","DOI":"10.1002\/jbmr.4033"},{"key":"94","doi-asserted-by":"publisher","unstructured":"94 Morelli V, Favero V, Frigerio S, Aresta C, Pugliese F, et al. (2025) Adrenalectomy reduces the risk of vertebral fractures in patients with mild autonomous cortisol secretion. J Clin Endocrinol Metab. doi: 10.1210\/clinem\/dgaf227 Online ahead of print.","DOI":"10.1210\/clinem\/dgaf227"},{"key":"95","doi-asserted-by":"publisher","unstructured":"95 Schoeb M, Sintenie PJC, Bakker LEH, Biermasz NR, van Haalen FM, et al. (2024) Bone material strength index is low in patients with Cushing\u2019s syndrome even after long-term remission. <i>J Clin Endocrinol Metab<\/i>. doi: 10.1210\/clinem\/dgae799 Online ahead of print.","DOI":"10.1210\/clinem\/dgae799"},{"key":"96","doi-asserted-by":"crossref","unstructured":"96 Shi S, Lu C, Tian H, Ren Y, Chen T (2020) Primary aldosteronism and bone metabolism: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 11: 574151.","DOI":"10.3389\/fendo.2020.574151"},{"key":"97","doi-asserted-by":"publisher","unstructured":"97 Nanba K, Vaidya A, Williams GH, Zheng I, Else T, et al. (2017) Age-related autonomous aldosteronism. Circulation 136: 347\u2013355.","DOI":"10.1161\/CIRCULATIONAHA.117.028201"},{"key":"98","doi-asserted-by":"crossref","unstructured":"98 Tezuka Y, Atsumi N, Blinder AR, Rege J, Giordano TJ, et al. (2021) The age-dependent changes of the human adrenal cortical zones are not congruent. J Clin Endocrinol Metab 106: 1389\u20131397.","DOI":"10.1210\/clinem\/dgab007"},{"key":"99","doi-asserted-by":"crossref","unstructured":"99 Iwahashi N, Umakoshi H, Fujita M, Fukumoto T, Ogasawara T, et al. (2024) Single-cell and spatial transcriptomics analysis of human adrenal aging. Mol Metab 84: 101954.","DOI":"10.1016\/j.molmet.2024.101954"},{"key":"100","doi-asserted-by":"crossref","unstructured":"100 Huang K, Cai HL, Bao JP, Wu LD (2020) Dehydroepiandrosterone and age-related musculoskeletal diseases: connections and therapeutic implications. Ageing Res Rev 62: 101132.","DOI":"10.1016\/j.arr.2020.101132"},{"key":"101","doi-asserted-by":"crossref","unstructured":"101 Laughlin GA, Barrett-Connor E (2000) Sexual dimorphism in the influence of advanced aging on adrenal hormone levels: the Rancho Bernardo Study. J Clin Endocrinol Metab 85: 3561\u20133568.","DOI":"10.1210\/jc.85.10.3561"},{"key":"102","doi-asserted-by":"crossref","unstructured":"102 Van Cauter E, Leproult R, Kupfer DJ (1996) Effects of gender and age on the levels and circadian rhythmicity of plasma cortisol. J Clin Endocrinol Metab 81: 2468\u20132473.","DOI":"10.1210\/jcem.81.7.8675562"},{"key":"103","doi-asserted-by":"crossref","unstructured":"103 Nawata H, Tanaka S, Tanaka S, Takayanagi R, Sakai Y, et al. (1995) Aromatase in bone cell: association with osteoporosis in postmenopausal women. J Steroid Biochem Mol Biol 53: 165\u2013174.","DOI":"10.1016\/0960-0760(95)00031-T"},{"key":"104","doi-asserted-by":"crossref","unstructured":"104 Wang L, Wang YD, Wang WJ, Zhu Y, Li DJ (2007) Dehydroepiandrosterone improves murine osteoblast growth and bone tissue morphometry <i>via<\/i> mitogen-activated protein kinase signaling pathway independent of either androgen receptor or estrogen receptor. J Mol Endocrinol 38: 467\u2013479.","DOI":"10.1677\/jme.1.02173"},{"key":"105","unstructured":"105 Wang YD, Wang L, Li DJ, Wang WJ (2006) Dehydroepiandrosterone inhibited the bone resorption through the upregulation of OPG\/RANKL. Cell Mol Immunol 3: 41\u201345."},{"key":"106","doi-asserted-by":"crossref","unstructured":"106 Lee D, Kim H, Ahn SH, Lee SH, Bae SJ, et al. (2015) The association between serum dehydroepiandrosterone Sulphate (DHEA-S) level and bone mineral density in Korean men. Clin Endocrinol (Oxf) 83: 173\u2013179.","DOI":"10.1111\/cen.12755"},{"key":"107","doi-asserted-by":"crossref","unstructured":"107 Khosla S, Melton LJ 3rd, Atkinson EJ, O\u2019Fallon WM, Klee GG, et al. (1998) Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: a key role for bioavailable estrogen. J Clin Endocrinol Metab 83: 2266\u20132274.","DOI":"10.1210\/jc.83.7.2266"},{"key":"108","doi-asserted-by":"crossref","unstructured":"108 Greendale GA, Edelstein S, Barrett-Connor E (1997) Endogenous sex steroids and bone mineral density in older women and men: the Rancho Bernardo Study. J Bone Miner Res 12: 1833\u20131843.","DOI":"10.1359\/jbmr.1997.12.11.1833"},{"key":"109","doi-asserted-by":"crossref","unstructured":"109 Nair KS, Rizza RA, O\u2019Brien P, Dhatariya K, Short KR, et al. (2006) DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med 355: 1647\u20131659.","DOI":"10.1056\/NEJMoa054629"},{"key":"110","doi-asserted-by":"crossref","unstructured":"110 Jankowski CM, Gozansky WS, Schwartz RS, Dahl DJ, Kittelson JM, et al. (2006) Effects of dehydroepiandrosterone replacement therapy on bone mineral density in older adults: a randomized, controlled trial. J Clin Endocrinol Metab 91: 2986\u20132993.","DOI":"10.1210\/jc.2005-2484"},{"key":"111","doi-asserted-by":"crossref","unstructured":"111 Baulieu EE, Thomas G, Legrain S, Lahlou N, Roger M, et al. (2000) Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci U S A 97: 4279\u20134284.","DOI":"10.1073\/pnas.97.8.4279"},{"key":"112","doi-asserted-by":"crossref","unstructured":"112 von M\u00fchlen D, Laughlin GA, Kritz-Silverstein D, Bergstrom J, Bettencourt R (2008) Effect of dehydroepiandrosterone supplementation on bone mineral density, bone markers, and body composition in older adults: the DAWN trial. Osteoporos Int 19: 699\u2013707.","DOI":"10.1007\/s00198-007-0520-z"},{"key":"113","doi-asserted-by":"crossref","unstructured":"113 Ohlsson C, Nethander M, Kindmark A, Ljunggren \u00d6, Lorentzon M, et al. (2017) Low serum DHEAS predicts increased fracture risk in older men: the MrOS Sweden Study. J Bone Miner Res 32: 1607\u20131614.","DOI":"10.1002\/jbmr.3123"},{"key":"114","doi-asserted-by":"crossref","unstructured":"114 Garnero P, Sornay-Rendu E, Claustrat B, Delmas PD (2000) Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study. J Bone Miner Res 15: 1526\u20131536.","DOI":"10.1359\/jbmr.2000.15.8.1526"},{"key":"115","doi-asserted-by":"crossref","unstructured":"115 Barrett-Connor E, Kritz-Silverstein D, Edelstein SL (1993) A prospective study of dehydroepiandrosterone sulfate (DHEAS) and bone mineral density in older men and women. Am J Epidemiol 137: 201\u2013206.","DOI":"10.1093\/oxfordjournals.aje.a116660"},{"key":"116","doi-asserted-by":"crossref","unstructured":"116 Weiss EP, Shah K, Fontana L, Lambert CP, Holloszy JO, et al. (2009) Dehydroepiandrosterone replacement therapy in older adults: 1- and 2-y effects on bone. Am J Clin Nutr 89: 1459\u20131467.","DOI":"10.3945\/ajcn.2008.27265"},{"key":"117","doi-asserted-by":"crossref","unstructured":"117 Morales AJ, Haubrich RH, Hwang JY, Asakura H, Yen SS (1998) The effect of six months treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex steroids, body composition and muscle strength in age-advanced men and women. Clin Endocrinol (Oxf) 49: 421\u2013432.","DOI":"10.1046\/j.1365-2265.1998.00507.x"},{"key":"118","doi-asserted-by":"crossref","unstructured":"118 Corona G, Rastrelli G, Giagulli VA, Sila A, Sforza A, et al. (2013) Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo-controlled trials. J Clin Endocrinol Metab 98: 3615\u20133626.","DOI":"10.1210\/jc.2013-1358"},{"key":"119","doi-asserted-by":"crossref","unstructured":"119 Elraiyah T, Sonbol MB, Wang Z, Khairalseed T, Asi N, et al. (2014) Clinical review: the benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis. J Clin Endocrinol Metab 99: 3536\u20133542.","DOI":"10.1210\/jc.2014-2261"},{"key":"120","doi-asserted-by":"crossref","unstructured":"120 Yokomoto-Umakoshi M, Umakoshi H, Iwahashi N, Matsuda Y, Kaneko H, et al. (2021) Protective role of DHEAS in age-related changes in bone mass and fracture risk. J Clin Endocrinol Metab 106: e4580\u2013e4592.","DOI":"10.1210\/clinem\/dgab459"},{"key":"121","doi-asserted-by":"crossref","unstructured":"121 Katsuhara S, Yokomoto-Umakoshi M, Umakoshi H, Matsuda Y, Iwahashi N, et al. (2022) Impact of cortisol on reduction in muscle strength and mass: a mendelian randomization study. J Clin Endocrinol Metab 107: e1477\u2013e1487.","DOI":"10.1210\/clinem\/dgab862"},{"key":"122","doi-asserted-by":"crossref","unstructured":"122 Dennison E, Hindmarsh P, Fall C, Kellingray S, Barker D, et al. (1999) Profiles of endogenous circulating cortisol and bone mineral density in healthy elderly men. J Clin Endocrinol Metab 84: 3058\u20133063.","DOI":"10.1210\/jc.84.9.3058"},{"key":"123","doi-asserted-by":"crossref","unstructured":"123 Reynolds RM, Dennison EM, Walker BR, Syddall HE, Wood PJ, et al. (2005) Cortisol secretion and rate of bone loss in a population-based cohort of elderly men and women. 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