Coexistence of osteoporosis and atherosclerosis in pheochromocytoma: new insights into its long-term management
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ORIGINAL ARTICLE
Coexistence of osteoporosis and atherosclerosis in pheochromocytoma: new insights into its long-term management M. Yokomoto-Umakoshi 1 & H. Umakoshi 1 & M. Ogata 1 & T. Fukumoto 1 & Y. Matsuda 1 & T. Miyazawa 1 & R. Sakamoto 1 & Y. Ogawa 1 & the Q-AND-A study group
Received: 7 April 2020 / Accepted: 26 June 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary Osteoporosis and atherosclerosis frequently coexist in patients with pheochromocytoma. The presence of osteoporosis may predict that of atherosclerosis and vice versa in patients with PHEO. These findings have implications for the long-term management of the pheochromocytoma and its potential chronic complications. Introduction Pheochromocytoma (PHEO), a catecholamine-producing tumor, is often found incidentally, and it may be present for years before it is diagnosed. However, long-term exposure to catecholamines excess may induce chronic complications, such as osteoporosis and atherosclerosis. We aimed to evaluate concomitant osteoporosis and atherosclerosis in patients with PHEO. Methods Fifty-one patients with PHEO and 51 patients with a non-functional adrenal tumor were compared radiographically for the prevalence of vertebral fracture (VF), a typical osteoporotic fracture, and abdominal aortic calcification (AAC). Results In patients with PHEO, the prevalence of AAC was higher in those with VF (58%) than in those without (6%, p < 0.001). AAC was associated with VF after adjusting for age and sex (odds ratio, 1.53; 95% confidence interval, 1.07–2.46; p = 0.003) in patients with PHEO. The degree of catecholamine excess correlated with the presence of VF and AAC (p = 0.007). The prevalence of VF was higher in patients with PHEO (37%) than those with non-functional AT (12%, p = 0.005), but the prevalence of AAC was comparable between the two groups (25% and 19%, p = 0.636). VF and AAC more frequently coexisted in patients with PHEO (22%) than in those with non-functional AT (2%, p = 0.003). Conclusion This study represents the first demonstration that osteoporosis and atherosclerosis frequently coexist in patients with PHEO. The presence of osteoporosis may predict that of atherosclerosis and vice versa in patients with PHEO. These findings have implications for the long-term management of the PHEO and its potential chronic complications. Keywords Abdominal aortic calcification . Atherosclerosis . Catecholamine . Osteoporosis . Pheochromocytoma . Vertebral fracture
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00198-020-05527-5) contains supplementary material, which is available to authorized users. * H. Umakoshi [email protected] * Y. Ogawa [email protected] 1
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Pheochromocytoma (PHEO), a catecholamine-producing neuroendocrine tumor, has effects on both hemodynamics and energy metabolism,
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