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Coexistence of osteoporosis and atherosclerosis in pheochromocytoma: new insights into its long-term management

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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.

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Acknowledgments

We thank for Ms. Chitose Matsuzaki for technical assistance. We also thank the medical staff of Kyushu University Hospital Department of Endocrinology, Metabolism, and Diabetes for their support. Finally, we thank Mark Cleasby, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

This work was supported by the Kyushu University Research Activity Support Program, Support for Women Returning from Maternity and Parental Leave.

Availability of data and material

The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    M. Yokomoto-Umakoshi, H. Umakoshi, M. Ogata, T. Fukumoto, Y. Matsuda, T. Miyazawa, R. Sakamoto & Y. Ogawa

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  1. M. Yokomoto-Umakoshi
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  2. H. Umakoshi
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  3. M. Ogata
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  4. T. Fukumoto
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  6. T. Miyazawa
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  7. R. Sakamoto
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  8. Y. Ogawa
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the Q-AND-A study group

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Yokomoto-Umakoshi, M., Umakoshi, H., Ogata, M. et al. Coexistence of osteoporosis and atherosclerosis in pheochromocytoma: new insights into its long-term management. Osteoporos Int 31, 2151–2160 (2020). https://doi.org/10.1007/s00198-020-05527-5

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