Bone mineral density in acromegaly: the effect of gender, disease activity and gonadal status
Open accessAbstract
Summary: objective Data on bone mineral density (BMD) in acromegaly are conflicting as most previous studies collectively evaluated eugonadal and hypogonadal patients of both sexes, with or without active disease. We have evaluated BMD in 152 acromegalic patients of both sexes with varying disease activity and gonadal status. design Cross‐sectional, retrospective. patients We studied 152 acromegalic patients (99 women aged 26–72 years, and 53 men aged 21–75 years), 107 with active and 45 with controlled disease. Eighty‐five patients had normal gonadal status and 67 were hypogonadal. measurements In all patients we measured serum GH levels by immunoenzimometric assay, and serum IGF‐I levels by radioimmunoassay. BMD was assessed at spine L2–L4 (LS) and at femoral neck (FN) by dual energy X‐ray absorptiometry; results are expressed as Z‐values. results We evaluated the effect of GH excess on bone at different sites in relation to gonadal status, disease activity and gender. At LS, in respect to the reference population, BMD (mean ± SE) values were higher in eugonadal patients (active: 0·71 ± 0·29, P < 0·02; controlled: 0·65 ± 0·28, P < 0·05) and lower in hypogonadal ones (active: −0·64 ± 0·35, 0·1 < P < 0·05; controlled: −1·05 ± 0·36, P < 0·01), regardless of disease activity. On the contrary, at FN, BMD was higher than in the reference population, both in eugonadal (1·01 ± 0·22, P < 0·001) and hypogonadal (0·63 ± 0·17, P < 0·001) patients only in subjects with active disease, but not in those in which the disease was controlled (eugonadal: 0·31 ± 0·23, P = ns; hypogonadal 0·04 ± 0·28, P = ns). We did not observe any difference in BMD values according to gender both at LS (males vs. females −0·02 ± 0·30 vs. 0·01 ± 0·24, P = ns) or at FN (0·77 ± 0·19 vs. 0·63 ± 0·15, P = ns). conclusions The anabolic effect of GH excess on bone in acromegalic patients is: (i) gender‐independent; (ii) evident at the spine only in eugonadal regardless of disease activity; (iii) evident at femoral neck only in the presence of active disease regardless of gonadal status.
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Conflicting data on bone mineral density in acromegaly might be related to gonadal status, different skeletal sites measured, various techniques employed, subject's gender, age, and activity of the disease.
“Conflicting data on bone mineral density might be related to gonadal status, different skeletal sites being measured, various techniques employed, subject's gender, age, and activity of the disease [28, 36, 38].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [36]
The Abstract and Discussion attribute conflicting BMD findings to differences in gonadal status, disease activity, gender-related stratification, and skeletal site. The Measurements section accounts for patients’ ages and different devices, but the paper does not identify age or measurement techniques as reasons previous studies conflicted. (LLM, conf=0.86)
Experimental — accuracy not yet measuredInformation 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 [36]
Scillitani et al. reported that the anabolic effect of GH excess on bone in acromegalic patients is gender independent, evident only at the spine in eugonadal patients regardless of disease activity, and present only at the femoral neck during active disease regardless of gonadal status.
“Scillitani et al. reported that the anabolic effect of GH excess on bone in acromegalic patients is gender independent, evident only at the spine in eugonadal patients regardless of disease activity and present only at femoral neck during active disease regardless of gonadal status [36].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [36]
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References 21 · Cited by 63
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- Authors
- Scillitani, A., Battista, C., Chiodini, I., Carnevale, V., Fusilli, S., Ciccarelli, E., Terzolo, M., Oppizzi, G., Arosio, M., Gasperi, M., Arnaldi, G., Colao, A., Baldelli, R., Ghiggi, M. R., Gaia, D., Di Somma, C., Trischitta, V., & Liuzzi, A.
- Affiliations
- Casa Sollievo della Sofferenza (IT)
- University of Turin (IT)
- Ospedale San Luigi Gonzaga (IT)
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- University of Milan (IT)
- University of Pisa (IT)
- Federico II University Hospital (IT)
- Sapienza University of Rome (IT)
- IRCCS Istituto Auxologico Italiano (IT)
- Corresponding author
- Scillitani, Alfredo
- ORCID
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2003-06
- Volume
- 58
- Issue
- 6
- Pages
- 725-731
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2060510593
- Cited by
- 63
- References
- 21
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 4 · 2016: 2 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 3
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Archivio Istituzionale della Ricerca - Università degli Studi del Molise (submittedVersion)
- IRIS UniPA (University of Palermo) (submittedVersion, other-oa)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (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, bone mineral density, hypogonadism, growth hormone excess, insulin-like growth factor I, disease activity, gonadal status, sex differences, femoral neck, lumbar spine, osteoporosis, bone loss, disease control, bone turnover markers, bone resorption, bone mineral area, bone mineral volume
- MeSH terms
- Acromegaly, Acute Disease, Adult, Aged, Cross-Sectional Studies, Female, Femur Neck, Humans, Hypogonadism, Insulin-Like Growth Factor I, Male, Middle Aged, Retrospective Studies, Sex, Growth Hormone, Spine, Absorptiometry, Photon, Bone Density
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