The Relations Of Subclinical Hypercortisolismand Osteoporosis:a Syetematic Reviewand Meta-analysis

BackgroundOsteoporosis is a complex diseases with the characteristic of reducedbone strength and increased risk in fracture,which is one of the commoncomplications of hypercortisolism. In recent years, a group of concept withSubclinical Hypercortisolism (SH) and adrenal incidentaloma have be givenmore and more attention, In addition,the morbidity of SH in adrenalincidentaloma isn’t low. A lot of researchs revealed that hypercortisolismcan cause osteoporosis, but, it is unclear whether SH also can causeosteoporosis. The experts have worked out of observation researchs aroundthis problem.In this paper,we have a systematic analysis of the researchs.ObjectiveTo explore the relations of SH and osteoprosis.MethodsWe retrieved MEDLINE、BIOSIS Previews、High Wire WanfangDatabase, Vip Database for articles about the relations of SH and osteoporosis. Searches were limited to Chinese/English-language publication s. The clinical outcomes evaluated for this study included bone mineraldensity、biochemical markers of bone turnover、the prevalence of osteoporosis、the incidence of fracture.we do meta-analysis by RevMan5forthis literature which is selected according to inclusion and exclusion criteria and evaluated the quality.ResultsWe included15studies at all,it contains6retrospective studies、6prospective studies and3intervention studies. Retrospective studies have shown that bone mineral density levels in Subclinical Hypercortisolism (SH+) group was significantly lower than in the nonSubclinical Hypercortisolism (SH-) group，meta-analysis of prospective studies show that the level of bone mineral density at lumbar spine and femoral neck wassignificantly lower in SH+group than the SH-group，both retrospectivestudies and prospective studies have shown biochemical marker of boneturnover is lower in SH+group than the SH-group，but not significantly; intervention studies have shown that we can not improve the prognosis of SH patients with surgical intervention.ConclusionSH can reduce bone mineral density at lumbar spine and femoral neck,increase the prevalence of osteoporosis and incidence of fracture. We cannot clearly answer whether the SH patients with osteoporosis remainbenefit with surgical intervention. It remains to be further studied.