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High Evening Cortisol Level Is Associated With Low TBS and Increased Prevalent Vertebral Fractures: OsteoLaus Study

Gonzalez Rodriguez, Elena ; Lamy, Olivier ; Stoll, Delphine ; Metzger, Marie ; Preisig, Martin ; Kuehner, Christine ; Vollenweider, Peter ; Marques-Vidal, Pedro ; Waeber, Gérard ; Aubry-Rozier, Bérengère ; Hans, Didier

In: The Journal of Clinical Endocrinology & Metabolism, 2017, vol. 102, no. 7, p. 2628-2636

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    Title
    • High Evening Cortisol Level Is Associated With Low TBS and Increased Prevalent Vertebral Fractures: OsteoLaus Study
    Author
    • Gonzalez Rodriguez, Elena. Center for Bone Diseases, Rheumatology Unit, Bone and Joint Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    • Lamy, Olivier. Center for Bone Diseases, Rheumatology Unit, Bone and Joint Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    • Stoll, Delphine. Center for Bone Diseases, Rheumatology Unit, Bone and Joint Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    • Metzger, Marie. Center for Bone Diseases, Rheumatology Unit, Bone and Joint Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    • Preisig, Martin. Epidemiology and Psychopathology Research Unit, Psychiatric Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    • Kuehner, Christine. Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 58159 Mannheim, Germany
    • Vollenweider, Peter. Internal Medicine Unit, Internal Medicine Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    • Marques-Vidal, Pedro. Internal Medicine Unit, Internal Medicine Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    • Waeber, Gérard. Internal Medicine Unit, Internal Medicine Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    • Aubry-Rozier, Bérengère. Center for Bone Diseases, Rheumatology Unit, Bone and Joint Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    • Hans, Didier. Center for Bone Diseases, Rheumatology Unit, Bone and Joint Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • The Journal of Clinical Endocrinology & Metabolism, 2017, vol. 102, no. 7, p. 2628-2636. Endocrine Society
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:331367
    Summary
    Abstract Context: Increased evening cortisol levels have been implicated in bone mineral density (BMD) loss. The effect on bone microarchitecture and fracture risk has never been studied. Objective: To study the relationship between salivary cortisol circadian rhythm and (1) trabecular bone score (TBS) and (2) fracture prevalence. Design, Setting, Patients, and Interventions: Cross-sectional study including 608 women >50 years old (mean = 65.5) from the OsteoLaus cohort. Data included the FRAX© questionnaire, BMD, TBS and vertebral fracture (VFx) assessment by dual X-ray absorptiometry, and measures of salivary cortisol (awakening, 30 minutes thereafter, 11 am, and 8 pm). Results: In the multivariate model, participants in the highest tertile of 8 pm salivary cortisol (sc-8 pm) (mean = 5.7 ± 2.5 nmol/L) vs lowest tertile (1.7 ± 0.4 nmol/L) had lower TBS values (1.27 vs 1.29; P = 0.02), more prevalent VFx grades 2 and 3 (odds ratio = 5.34; P = 0.012), low-trauma fractures (odds ratio = 1.80; P = 0.036), and major osteoporotic fractures (odds ratio = 1.96; P = 0.042), without difference in lumbar spine BMD (0.91 vs 0.92 g/cm2; P = 0.431). VFx prevalence was associated with sc-8 pm and TBS independently of each other and of other risk factors. The cut-point for sc-8 pm correlating with the presence of >1 VFx was 3.62 nmol/L (sensitivity 0.74, specificity 0.66). Conclusions: High sc-8 pm is associated with low TBS and an increased prevalence of radiologic VFx independently of other risk factors. Measurement of sc-8 pm may add relevant information in the assessment of fracture risk.