Evaluation of Bone Mineral Densitometry Measurements in Newly Diagnosed Acromegaly Patients
PDF
Cite
Share
Request
Original Investigation
P: 91-96
August 2022

Evaluation of Bone Mineral Densitometry Measurements in Newly Diagnosed Acromegaly Patients

Turk J Osteoporos 2022;28(2):91-96
1. Sağlık Bilimleri Üniversitesi, Dışkapı Yıldırım Beyazıt Eğitim Araştırma Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, Ankara, Türkiye
2. Mardin Devlet Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, Mardin, Türkiye
No information available.
No information available
Received Date: 21.05.2021
Accepted Date: 16.07.2021
Publish Date: 11.08.2022
PDF
Cite
Share
Request

ABSTRACT

Objective:

Acromegaly is a chronic disease that causes high concentrations of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). GH and IGF-1 levels have important effects on bone homeostasis, bone turnover, and bone remodeling. The results of studies investigating the relationship between acromegaly and bone mineral density (BMD) are controversial. The aim of the current study was to evaluate BMD in newly diagnosed acromegaly patients and to determine the relationship between GH and IGF-1 levels with BMD.

Materials and Methods:

This cross-sectional study was conducted on 36 newly diagnosed acromegaly patients without a history of hypogonadism, whose BMD values can be obtained from the records of University of Health Sciences Turkey, Dışkapı Yıldırım Beyazıt Training and Research Hospital. The relationship between GH and IGF-1 levels and BMD measured from the femur and lumbar regions was examined separately.

Results:

The mean age of the patients was 46.2±12.5 years. Median IGF-1 and BH levels were 551 ng/mL and 8.2 ng/mL, respectively. While 58.3% of the patients had osteopenia, no osteoporosis was found in any patient. A positive correlation was found between the BMD value measured from the femoral neck and IGF-1 (r=0.484, p=0.036) and GH (r=0.595, p=0.007) levels. There was no significant correlation between BMD measurements evaluated from lumbar vertebrae and GH and IGF-1 levels.

Conclusion:

It was found that the increase in GH and IGF-1 levels in newly diagnosed eugonadal acromegaly patients increased BMD measured from the femur. There was no significant relationship between BMD measured from the lumbar region and GH and IGF-1 levels.

References

1
Katznelson L, Laws ER Jr, Melmed S, Molitch ME, Murad MH, Utz A, et al. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014;99:3933-51. 
2
Andersen M. Management of endocrine disease: GH excess: diagnosis and medical therapy. Eur J Endocrinol 2013;170:R31-41. 
3
Nabarro JD. Acromegaly. Clin Endocrinol (Oxf) 1987;26:481-512.
4
Giustina A, Mazziotti G, Canalis E. Growth hormone, insulin-like growth factors, and the skeleton. Endocr Rev 2008;29:535-59.
5
Claessen KM, Mazziotti G, Biermasz NR, Giustina A. Bone and Joint Disorders in Acromegaly. Neuroendocrinology 2016;103:86-95. 
6
Eugster EA, Pescovitz OH. Gigantism. J Clin Endocrinol Metab 1999;84:4379-84.
7
Ueland T, Fougner SL, Godang K, Schreiner T, Bollerslev J. Serum GH and IGF-I are significant determinants of bone turnover but not bone mineral density in active acromegaly: a prospective study of more than 70 consecutive patients. Eur J Endocrinol 2006;155:709-15.
8
Bianda T, Hussain MA, Glatz Y, Bouillon R, Froesch ER, Schmid C. Effects of short-term insulin-like growth factor-I or growth hormone treatment on bone turnover, renal phosphate reabsorption and 1,25 dihydroxyvitamin D3 production in healthy man. J Intern Med 1997;241:143-50.
9
Kamenický P, Blanchard A, Gauci C, Salenave S, Letierce A, Lombès M, et al. Pathophysiology of renal calcium handling in acromegaly: what lies behind hypercalciuria? J Clin Endocrinol Metab 2012;97:2124-33. 
10
Anthony JR, Ioachimescu AG. Acromegaly and bone disease. Curr Opin Endocrinol Diabetes Obes 2014;21:476-82. 
11
Kaji H, Sugimoto T, Nakaoka D, Okimura Y, Kaji H, Abe H, et al. Bone metabolism and body composition in Japanese patients with active acromegaly. Clin Endocrinol (Oxf) 2001;55:175-81. 
12
Diamond T, Nery L, Posen S. Spinal and peripheral bone mineral densities in acromegaly: the effects of excess growth hormone and hypogonadism. Ann Intern Med 1989;111:567-73. 
13
Kotzmann H, Bernecker P, Hübsch P, Pietschmann P, Woloszczuk W, Svoboda T, et al. Bone mineral density and parameters of bone metabolism in patients with acromegaly. J Bone Miner Res 1993;8:459-65. 
14
Bolanowski M, Halupczok J, Jawiarczyk-Przybyłowska A. Pituitary disorders and osteoporosis. Int J Endocrinol 2015;2015:206853. 
15
Kayath MJ, Vieira JG. Osteopenia occurs in a minority of patients with acromegaly and is predominant in the spine. Osteoporos Int 1997;7:226-30. 
16
Scillitani A, Battista C, Chiodini I, Carnevale V, Fusilli S, Ciccarelli E, et al. Bone mineral density in acromegaly: the effect of gender, disease activity and gonadal status. Clin Endocrinol (Oxf) 2003;58:725-31.
17
Madeira M, Neto LV, de Paula Paranhos Neto F, Barbosa Lima IC, Carvalho de Mendonça LM, Gadelha MR, et al. Acromegaly has a negative influence on trabecular bone, but not on cortical bone, as assessed by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 2013;98:1734-41.
18
Padova G, Borzì G, Incorvaia L, Siciliano G, Migliorino V, Vetri M, et al. Prevalence of osteoporosis and vertebral fractures in acromegalic patients. Clin Cases Miner Bone Metab 2011;8:37-43.
19
Mazziotti G, Biagioli E, Maffezzoni F, Spinello M, Serra V, Maroldi R, et al. Bone turnover, bone mineral density, and fracture risk in acromegaly: a meta-analysis. J Clin Endocrinol Metab 2015;100:384-94. 
20
Bolanowski M, Daroszewski J, Medraś M, Zadrozna-Sliwka B. Bone mineral density and turnover in patients with acromegaly in relation to sex, disease activity, and gonadal function. J Bone Miner Metab 2006;24:72-8. 
21
Qin L, Guo X, Gao L, Wang Z, Feng C, Deng K, et al. Preoperative and Postoperative Bone Mineral Density Change and Risk Factor Analysis in Patients with a GH-Secreting Pituitary Adenoma. Int J Endocrinol 2019;2019:2102616. 
22
Wassenaar MJ, Biermasz NR, Hamdy NA, Zillikens MC, van Meurs JB, Rivadeneira F, et al. High prevalence of vertebral fractures despite normal bone mineral density in patients with long-term controlled acromegaly. Eur J Endocrinol 2011;164:475-83. 
23
Mazziotti G, Bianchi A, Bonadonna S, Cimino V, Patelli I, Fusco A, et al. Prevalence of vertebral fractures in men with acromegaly. J Clin Endocrinol Metab 2008;93:4649-55.