Adrenal (Excluding Mineralocorticoids)

SAT-423 - Inflammatory markers link steroid profiles to bone status in patients with autonomous cortisol secretion

Saturday, June 13, 2026

9:30 AM - 4:30 PM CT

Late-Breaking Poster Presenter(s)

YK

Yuya Kitamura, MD

Kyushu university
Fukuoka, Japan

Co-Author(s)

MY

Maki Yokomoto-Umakoshi, MD, PhD

KYUSHU UNIVERSITY
Fukuoka, Fukuoka, Japan
YN

Yui Nakano, MD

Kyushu university
Fukuoka, Japan
KN

Kohta Nakatani, PhD

Niigata university
Niigata, Niigata, Japan
HU

Hironobu Umakoshi, PhD

Medicine and Bioregulatory Science Graduate School of Medical Science, Kyushu University
Fukuoka, Japan
HN

Hiroshi Nakao, MD, PhD

Kyushu university
Fukuoka city, Fukuoka, Japan
HK

Hiroki Kaneko, MD, PhD

Kyushu university
Fukuoka, Fukuoka, Japan
NI

Norifusa Iwahashi, MD, PhD

Kyushu University
Fukuoka, Fukuoka, Japan
Masamichi Fujita, MD, PhD

Kyushu University
Fukuoka, JAPAN
TO

Tatsuki Ogasawara, MD, PhD

Kyushu university
Fukuoka, Fukuoka, Japan
TF

Tazuru Fukumoto, MD, PhD

Kyushu university
Fukuoka, Fukuoka, Japan
RS

Ryuichi Sakamoto, MD, PhD

Kyushu university
Fukuoka, Japan
YI

Yoshihiro Izumi, PhD

The University of Osaka
osaka, Osaka, Japan
TB

Takeshi Bamba, PhD

The University of Osaka
Osaka, Osaka, Japan

Senior Author/Primary Investigator(s)

YO

Yoshihiro Ogawa, MD, PhD

Kyushu University
Fukuoka, Japan

Disclosure(s):

Masamichi Fujita, MD, PhD: No financial relationships to disclose

Context: Autonomous cortisol secretion (ACS) is a common cause of endogenous glucocorticoid-induced osteoporosis. Cortisol excess alone, however, does not fully explain altered bone status, and other steroid hormone changes, including androgen deficiency, may contribute. ACS is also associated with an inflammatory state, which may relate to changes in bone status and steroid profiles.

Purpose: To investigate whether inflammatory markers are associated with bone status and steroid profiles in ACS and explore their potential mediating role.

Methods: Inflammatory markers and bone status were assessed in 106 patients with ACS and 95 with non-functioning adrenal tumors (NFAT). Of these, plasma steroid profiles were measured by liquid chromatography–tandem mass spectrometry in 64 patients with ACS and 77 with NFAT. Analyses examining associations between inflammatory markers and bone status or steroid profiles were stratified by sex and menopausal status.

Results: ACS showed higher systemic immune-inflammation index (SII) and lower prognostic nutritional index (PNI) than NFAT. In premenopausal women with ACS, SII negatively correlated with trabecular bone score (TBS) (r = -0.38), while PNI positively correlated with TBS (r = 0.58). Androsterone-glucuronide (AND-G), an androgen metabolite, was negatively correlated with SII (r = -0.59) and positively with PNI (r = 0.74). SHapley Additive exPlanations and Bayesian Kernel Machine Regression identified AND-G as the strongest contributor to PNI. PNI mediated 59.9% of the association between AND-G and TBS.
Main conclusions: Inflammatory markers were associated with deteriorated bone quality, especially in premenopausal women with ACS. Androgen deficiency was associated with inflammation, partially contributing to bone deterioration.

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