CLINICAL STUDY Increased risk of osteoporotic fractures in patients with Cushing’s syndrome

Objective: To evaluate if fracture risk was increased in patients with Cushing’s syndrome due to the increased endogenous cortisol production. Design: Cohort. Methods: A self-administered questionnaire was mailed to 125 patients with Cushing’s syndrome diag-nosed between 1985 and 1999 in Denmark. The response of each patient was compared with that of three age- and gender-matched control subjects randomly drawn among respondents to the same questionnaire from the background population. Results: One hundred and four patients (83%) responded. The median age of the patients was 48 years (range 19–85 years). Sixty-eight had pituitary disease, 28 had adrenal disease, four had had both pitu-itary and adrenal surgery while four had not undergone surgery at the time of the study. The median time from diagnosis to surgery was 0.2 (range 0–3) years. Eighty-six percent were cured following sur-gery. There was an increased fracture risk within the last 2 years prior to diagnosis (incidence rate ratio 6.0, 95 % confidence intervals (CI): 2.1–17.2). More than 2 years prior to diagnosis and following diagnosis there was no difference in fracture risk between patients and controls. The patients ha