Pathophysiology of osteoporosis: role of hidden cortisol excess and its predictors in bone fragility

Hidden hypercortisolism (HidHyCo), a condition of cortisol excess in the absence of its classical signs and symptoms, is
associated with an increased risk of osteoporosis and fragility fractures, which are a significant cause of morbidity, mortality
and health care costs.
The HidHyCo screening in populations at risk is a matter of debate: the HidHyCo case finding is of utmost importance since
the resolution of cortisol excess can result in the improvement of bone strength and in the reduction of fracture risk.
The aim of the current project is the assessment of the prevalence of HidHyCo and of the characteristics predictive of the
presence of this condition in patients with apparently primary osteoporosis. Moreover, this project was aimed at evaluating
the pathogenetic mechanisms explaining the negative effects of this slight cortisol excess on bone and the potential role of
the genetic background and of the gut microbiome