Osteopenia occurs in a minority of patients with acromegaly and is predominant in the spine
Abstract
Acromegaly may induce abnormalities in bone metabolism; however, there are limited data related to bone mineral density (BMD) in this condition. To evaluate the effects of an excess of growth hormone/ insulin-like growth fractor I (GH/IGF-I) in the skeleton, we measured the BMD in spine and femoral region, total body calcium and body composition in 45 patients (24 females and 21 males) aged 21-77 years (median 43 years) with acromegaly for 11.4 +/- 7.5 years (range 0.5-26 years) using a dual-energy X-ray absorptiometer (Lunar DPX). Thirty-four patients had had hypogonadism for 8.6 +/- 6.5 years (1-24 years). Mean serum GH and IGF-I levels were respectively 159 +/- 183 micrograms/l and 843 +/- 497 micrograms/l. Total body calcium was increased in the acromegalics (males: 1272 +/- 217 g, range 916-1816 g; females: 1041 +/- 223 g, range 739-1609 g) when compared with normal individuals (males: 1115 +/- 144 g, range 856-1398 g; females: 909 +/- 144 g, range 511-1311 g; p = 0.01). The lean body mass was significantly higher in acromegalic patients (p < 0.001) compared with normal individuals. There was a tendency for a lower fat percentage in the acromegalics; however, this difference was not significant. Osteopenia (1 Z-score below the mean) was found in the spine in 20% (n = 9) of the patients, while BMD was decreased in the femoral region in only 8.8% (n = 4). The group with osteopenia had a greater duration of hypogonadism than the normal BMD group (14 +/- 11 years vs 4.4 +/-…
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Hypogonadal patients with acromegaly are at higher risk of osteoporosis, particularly at sites composed predominantly of trabecular bone.
“Hypogonadal patients with acromegaly are at higher risk of osteoporosis, particularly at sites composed predominantly of trabecular bone, which has more intimate contact with the circulation and is influenced by sex steroids to a greater extent [34, 39, 40].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [34]
Information about the influence of GH excess on BMD varies in the literature: in some studies BMD was increased or within reference ranges, while in other papers it was decreased.
“Information about the influence of GH excess on BMD varies in the literature. In some studies BMD was reported to be increased or within the reference ranges, while in other papers it was decreased [17, 26, 34–37].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [34]
Impaired gonadal status including hypogonadism and hyperprolactinemia is thought to be a cause of BMD decline in acromegaly.
“Impaired gonadal status including hypogonadism and hyperprolactinemia is thought to be a cause of BMD decline [28, 34].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [34]
Serum calcium and phosphate values and 24-hour urinary calcium are elevated in patients with active acromegaly.
“Additionally, serum calcium and phosphate values and 24-hour urinary calcium are elevated in patients with active disease [27, 29, 34, 35, 41].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [34]
Cites
Bone mineral density and parameters of bone metabolism in patients with acromegaly
Kotzmann, H., Bernecker, P., Hübsch, P., Pietschmann, P., Woloszczuk, W., Svoboda, T., Geyer, G., & Luger, A. (1993) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650080410 · Cited by 98 · see citing works
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Ueland, T., Fougner, S. L., Godang, K., Schreiner, T., & Bollerslev, J. (2006) · European Journal of Endocrinology · doi:10.1530/eje.1.02285 · Cited by 69 · see citing works
Pituitary Disorders and Osteoporosis
Bolanowski, M., Halupczok, J., & Jawiarczyk-Przybyłowska, A. (2015) · International Journal of Endocrinology · doi:10.1155/2015/206853 · Cited by 27 · see citing works
The risk of osteopenia in premenopausal women with various sellar tumors
Zhao, Y., Gan, X., Luo, P., He, Q., Guo, Q., Zhang, L., Zhang, X., Zhang, X., & Fei, Z. (2012) · Gynecological Endocrinology · doi:10.3109/09513590.2012.683080 · Cited by 10 · see citing works
- Authors
- Kayath, M. J., & Vieira, J. G. H.
- Affiliations
- Universidade Federal de São Paulo (BR)
- ORCID
- Vieira, J. G. H.
- Venue
- Osteoporosis International
- Published
- 1997-05
- Volume
- 7
- Issue
- 3
- Pages
- 226-230
- ISSN
- 0937-941X (ISSN-L)
- 1433-2965
- OpenAlex
- W2027471596
- Cited by
- 75
- References
- 1
- Citations by year
- 2024: 2 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 7 · 2017: 3 · 2016: 2 · 2015: 4 · 2014: 6 · 2013: 2 · 2012: 2
- FWCI
- 0.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Osteoporosis International (publishedVersion)
- PubMed (publishedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Keywords
- acromegaly, osteopenia, bone mineral density, spine, femoral bone density, hypogonadism, growth hormone excess, insulin-like growth factor I, bone metabolism, body composition, total body calcium, lean body mass, osteoporosis risk factors, sex differences, age differences, body weight
- MeSH terms
- Acromegaly, Adult, Aged, Body Composition, Bone Diseases, Metabolic, Calcium, Female, Humans, Hypogonadism, Insulin-Like Growth Factor I, Male, Middle Aged, Growth Hormone, Spinal Diseases, Time Factors, Absorptiometry, Photon, Bone Density, Body Mass Index
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