THU418 Steroid Profiles And Its Implication In Bone Mass And Quality In Premenopausal Women With Adrenal Tumors With Autonomous Cortisol Secretion

Abstract Disclosure: H. Nakao: None. K. Nakatani: None. M. Yokomoto-Umakoshi: None. H. Umakoshi: None. H. Kaneko: None. N. Iwahashi: None. M. Ogata: None. T. Fukumoto: None. F. Masamichi: None. O. Tatsuki: None. Y. Matsuda: None. R. Sakamoto: None. Y. Izumi: None. T. Bamba: None. Y. Ogawa: None. Context: Osteoporosis is a major complication in adrenal tumors with autonomous cortisol secretion (ACS). We conducted steroid profiling to elucidate how steroid metabolites affect bone mass and quality in patient with ACS. Methods: Ninety patients with ACS and 91 with non-functioning adrenal tumors (NFAT) were included, of whom 73 ACS (18 pre-, 26 postmenopausal women, and 29 men) and 85 NFAT (12 pre-, 34 postmenopausal women, and 39 men) were evaluated for 21 plasma steroid metabolites using liquid chromatography-tandem mass spectrometry. Results: Premenopausal women with ACS had lower lumbar spine (LS)-bone mineral density (BMD) and trabecular bone score (TBS) than those with NFAT. The discriminant and principal component analyses clearly separated ACS from NFAT in premenopausal women, but not in men and postmenopausal women. In premenopausal women, 8 steroid metabolites differed between ACS and NFAT, with 11-deoxycorticosterone having the largest effect size (Cohen’s d=1.600, false discovery rate (FDR)=1e-04). In premenopausal women with ACS, 11-deoxycorticosterone showed a negative correlation with LS-BMD Z-score (r=-0.603, FDR=0.064), and DHEA-S and androsterone-glucuronide showed a positive correlation with TBS (DHEA-S, r=0.647, FDR=0.019; androsterone-glucuronide r=0.681, FDR=0.020). The correlation of 11-deoxycorticosterone with LS-BMD Z-score and that of androsterone-glucuronide with TBS remained significant after adjustment for confounders. In men and postmenopausal women with ACS, no steroid metabolites evaluated were significantly correlated with BMD and TBS. Conclusion: This study provides the evidence for distinct steroid profiles in premenopausal women with ACS, suggesting that elevated 11-deoxycorticosterone, a mineralocorticoid metabolite, induces bone loss, and decreased androsterone-glucuronide, an androgen metabolite, deteriorates bone quality. Presentation: Thursday, June 15, 2023