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Cited by 147Pituitary Gland Disorders and TreatmentsGrowth Hormone and Insulin-like Growth FactorsBone health and osteoporosis research

Spinal and Peripheral Bone Mineral Densities in Acromegaly: The Effects of Excess Growth Hormone and Hypogonadism

Diamond, Terrence, Nery, Liza, Posen, Solomon·1989·Annals of Internal Medicine
DOI 10.7326/0003-4819-111-7-567
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Abstract

Study objective To measure spinal and peripheral bone mineral densities in patients with acromegaly. Design Retrospective study. Setting Tertiary care center. Subjects Twenty-four patients with acromegaly and 24 case controls. Seventeen patients (12 eugonadal and 5 hypogonadal) had "active" disease as indicated by elevated plasma concentrations of growth hormone or somatomedin C or both at the time of the study. Seven patients (all hypogonadal) had inactive disease by these criteria. Measurements and main results Bone mineral was measured by single photon absorptiometry of the forearm and dual photon absorptiometry of the spine. The forearm bone mineral content of patients with active disease, regardless of gonadal status, was significantly higher than that of normal subjects (P less than 0.001) or of patients with inactive disease (P less than 0.001). The disease "activity" (17.2 +/- 3.7; CI, 9.5 to 24.9) and the sex of the patient (female, -16.6 +/- 3.4; CI, -23.7 to -9.5) were the only independent predictors of forearm measurements. Vertebral bone densities were lower in acromegalic patients than in normal subjects (P less than 0.001). Vertebral values were correlated with the gonadal status of the patients (hypogonadism, -0.126 +/- 0.056; CI, -0.244 to -0.009) and with serum calcium concentrations (0.592 +/- 0.274; CI, 0.032 to 1.153) but not with acromegalic activity. In 13 patients, forearm bone was measured before and after treatment (mean duration of follow-up, 3.4 ye…

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  • Patients with acromegaly generally demonstrate increased cortical bone mass, whereas trabecular BMD is more variable.

    “Patients with acromegaly generally demonstrate increased cortical bone mass, whereas trabecular BMD is more variable [23, 35, 41, 42].”

    From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [41]

  • 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 [41]

  • In one study, forearm and vertebral BMD values changed in opposite directions; forearm BMD was increased because of GH and IGF-1 action and vertebral BMD was low due to hypogonadism.

    “In one study, forearm and vertebral BMD values changed in opposite directions. It seems that forearm BMD was increased because of GH and IGF-1 action and vertebral BMD was low due to hypogonadism [41].”

    From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [41]

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Authors
Diamond, T., Nery, L., & Posen, S.
Affiliations
Royal North Shore Hospital (AU)
Corresponding author
Diamond, Terrence
ORCID
Diamond, Terrence
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
1989-10-01
Volume
111
Issue
7
Pages
567-573
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/0003-4819-111-7-567
OpenAlex
W2092515948
Cited by
147
References
0
Citations by year
2025: 3 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 8 · 2017: 2 · 2016: 1 · 2015: 5 · 2014: 5 · 2013: 4
FWCI
3.20
Type
journal article
Language
en
Open access
closed
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
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, vertebral bone density, sex differences, serum calcium, bone turnover, disease activity monitoring, treatment response monitoring, bone gain, growth hormone therapy, somatostatin therapy, osteoporosis
MeSH terms
Acromegaly, Adult, Aged, Bone and Bones, Calcium, Female, Homeostasis, Humans, Hypogonadism, Insulin-Like Growth Factor I, Longitudinal Studies, Male, Middle Aged, Minerals, Radionuclide Imaging, Growth Hormone, Spine

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