Bone quality in patients with acromegaly

Czech version

Authors: Martin Kužma ¹; Ivana Ságová ²; Dušan Pávai ³; Peter Jackuliak ¹; Zdenko Killinger ¹; Peter Vaňuga ³; Juraj Payer ¹
Authors‘ workplace: V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava, Slovenská republika ¹; I. interná klinika JLF UK a UNM, Slovenská republika ²; Národný endokrinologický a diabetologický ústav, Ľubochňa, Slovenská republika ³
Published in: Vnitř Lék 2017; 63(9): 589-592
Category: Reviews

Overview

The impact of acromegaly on bone and the risk of fractures has not been sufficiently investigated. GH hypersecretion stimulates bone turnover, leading to an increase in bone turnover markers. Normal or even increased bone mineral density (BMD) in comparison to healthy controls have been reported, but there are some works where decreased BMD was observed among acromegaly patients with hypogonadism, particularly at lumbar spine. Less pronounced effect of GH overproduction was observed at the femoral neck, as explained by the positive effect of hypersecretion on the cortical bone (due to periosseal ossification). Several studies have documented morphometric vertebral fractures (VF) in 1/3 of acromegaly patients. The major risk factors leading to the development of VF include hypogonadism, diabetes mellitus and previous VF. Because the risk of fractures does not correlate with BMD most of the studies are currently focused on bone quality, bone strength and microstructure.

Key words:
bone microstructure – growth hormone – IGF1 – vertebral fractures

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