Prevalence, risk factors and management of bone complications in Cushing's syndrome across Europe. Data from the European Registry on Cushing's syndrome (ERCUSYN)
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: The aim of the study was to investigate bone comorbidities and their management in patients included in the European Register on Cushing's syndrome (ERCUSYN). DESIGN: A retrospective multicentric cohort study and on-line survey. METHODS: We analyzed the prevalence of osteoporosis (OP) and fractures among 1682 patients with Cushing's syndrome (CS), at initial evaluation and during follow-up. All the ERCUSYN partners received a survey addressing bone disease management in CS. RESULTS: Seven hundred and sixty-six patients (45%) had DXA examination at baseline, of whom 157 (21%) presented OP at spine and 103 (13%) at hip. Risk factors for OP were older age (P=0.038) and lower BMI (P=0.022). An X-ray was performed in 492 (29%) patients and fracture was detected in 87 (18%). Risk factors for fractures at baseline were male sex (P<0.001), muscle weakness (P=0.026) and bone mineral density (BMD) at hip indicating OP (P=0.026). During follow-up, spine BMD deterioration was more common in older patients (P=0.005) and in those with diabetes mellitus (P=0.024), while worsening of hip BMD was more frequent in patients with hypopituitarism (P=0.021), diabetes mellitus (P=0.034), on levothyroxine substitution (P=0.008) and those less often treated with anti-osteoporotic agents (P=0.022). The survey evidenced significant heterogeneity in terms of timing of bone evaluation and treatment initiation. CONCLUSIONS: A significant number of patients with CS experienced OP and fractures. Clinical factors may help to select patients at the highest risk. There are currently no standards of care for the management of bone complications in CS across Europe.
Source: Annales d Endocrinologie
Authors: Aleksandra Zdrojowy-Wełna, Claudia Amaral, Marta Araujo-Castro, Nienke Biermasz, Marek Bolanowski, Jens Bollerslev, Thierry Brue, Davide Carvalho, Frederic Castinetti, Filippo Ceccato, Justine Cristante, Daniela Dadej, Mario Detomas, Timo Deutschbein, Emanuele Ferrante, Atanaska Elenkova, Joan Gil, Ezio Ghigo, Aleksandra Gilis-Januszewska, Roberta Giordano, Miklos Goth, Cecile Greaud, Yona Greenman, Daniela Guelho, Irena Ilovayskaya, Sonia Kaniuka-Jakubowska, Darko Kastelan, Tomaz Kocjan, Irina Komerdus, Michal Krsek, Dominique Maiter, Olga Moros, Katarina Mlekuš Kozamernik, Eleni Papakokkinou, Giuseppe Reimondo, Oskar Ragnarsson, Martin Reincke, Helga Sigurjonsdottir, Christian J. Strasburger, Antoine Tabarin, Miklós Tóth, Greisa Vila, Birute Zilaitiene, Alicia Santos, Susan M. Webb, Elena Valassi
Institutions: Wroclaw Medical University, Hospital de Santo António, Hospital Universitario Ramón y Cajal, Leiden University Medical Center, University of Oslo, Inserm, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille, Hôpital de la Conception, Centre de Génétique Médicale de Marseille, Universidade do Porto, Hospital de São João, University of Padua, Azienda Ospedale - Università Padova, Centre Hospitalier Universitaire de Grenoble, Poznan University of Medical Sciences, University of Würzburg, Universitätsklinikum Würzburg, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Medical University of Sofia, Universitat Autònoma de Barcelona, Hospital de Sant Pau, Institut de Recerca Sant Pau, University of Turin, Jagiellonian University, Bicêtre Hospital, Tel Aviv University, Tel Aviv Sourasky Medical Center, Unidade Local de Saúde de Coimbra, Gdańsk Medical University, University Hospital Centre Zagreb, University of Ljubljana, Ljubljana University Medical Centre, Charles University, General University Hospital in Prague, Cliniques Universitaires Saint-Luc, UCLouvain, University of Gothenburg, LMU Klinikum, Ludwig-Maximilians-Universität München, University of Iceland, National University Hospital of Iceland, Charité - Universitätsmedizin Berlin, Centre Hospitalier Universitaire de Bordeaux, Semmelweis University, Medical University of Vienna, Lithuanian University of Health Sciences, Centre for Biomedical Network Research on Rare Diseases, Universitat Internacional de Catalunya
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,390
Funders: Hospital General Universitario Gregorio Marañón, Abbott Fund, Pfizer, Novartis, Aix-Marseille Université, Medical University Sofia, Università degli Studi di Milano, Ipsen Biopharmaceuticals, Esteve Pharmaceuticals, Recordati Rare Diseases, Society for Endocrinology, University of Sheffield, Institut National de la Santé et de la Recherche Médicale, Semmelweis Egyetem, Lundbeckfonden, Max-Planck-Gesellschaft, Universidad de Navarra, Centre National de la Recherche Scientifique, Leids Universitair Medisch Centrum, Latvijas Universitate, Háskóli Íslands, Medizinische Universität Wien, Radboud Universitair Medisch Centrum, Université de Bordeaux, Uludağ Üniversitesi, Istituto Auxologico Italiano, Ipsen, Sandoz, Novo Nordisk Pharma, Instituto de Salud Carlos III, Erasmus Universitair Medisch Centrum Rotterdam, Oslo universitetssykehus HF, Hospital Clínic de Barcelona
Awards: G5079291752, G6587313408, G6953774811
OpenAlex ID: W7127273186