The Severity of Bone Loss: A Comparison Between Cushing’s Disease and Cushing’s Syndrome
Bibliographic record
Abstract
Background: This study aimed to estimate the prevalence of osteoporosis among patients with adrenal Cushing’s syndrome (ACS) and Cushing’s disease (CD), to investigate whether there is a difference in the degree of osteoporosis between both groups; and if so, what factors may be responsible for this variation. Methods: This is a cross-sectional study in which data from 19 patients with CD and eight patients with ACS were analyzed. Osteoporosis was assessed using the bone mineral density (BMD) of the lumbar spine using dual-energy X-ray absorptiometry (DEXA). Results: Bone loss was present in 81.5% of the patients with Cushing’s syndrome. Osteoporosis is nearly three times more common in ACS (62.5%) than in CD (26.3%). BMD at the lumbar spine was lower in patients with ACS than in patients with CD. ACS had significantly lower levels of dehydroepiandrosterone sulfate (DHEA-S) than CD. In comparison to the CD group, the serum parathyroid hormone (PTH) concentration in the ACS group was significantly higher. In the entire patient population, there was a statistically significant correlation between the DHEA-S and the lumbar BMD values. Conclusions: Patients with ACS have more severe osteoporosis than patients with CD, and the difference in DHEA-S concentrations might be important in explaining this difference. BMD examinations should be prioritized to enable rapid recognition and intervention for osteoporosis. Measurement of bone turnover markers such as PTH may aid in the early diagnosis of the consequences of hypercortisolism on the bone. J Endocrinol Metab. 2023;13(1):33-38 doi: https://doi.org/10.14740/jem857
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".