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Endocortical Trabecularization in Acromegaly: The Cause for the Paradoxically Increased Vertebral Fracture Risk?
JBMR plus, 2023-10, Vol.7 (10), p.e10787-e10787
Heck, Ansgar
Godang, Kristin
Lekva, Tove
Markussen, Kjersti Norman
De Vincentis, Sara
Ueland, Thor
Bollerslev, Jens
2023
Details
Autor(en) / Beteiligte
Heck, Ansgar
Godang, Kristin
Lekva, Tove
Markussen, Kjersti Norman
De Vincentis, Sara
Ueland, Thor
Bollerslev, Jens
Titel
Endocortical Trabecularization in Acromegaly: The Cause for the Paradoxically Increased Vertebral Fracture Risk?
Ist Teil von
JBMR plus, 2023-10, Vol.7 (10), p.e10787-e10787
Ort / Verlag
Hoboken: John Wiley & Sons, Inc
Erscheinungsjahr
2023
Link zum Volltext
Quelle
Wiley HSS Collection
Beschreibungen/Notizen
ABSTRACT Growth hormone (GH) is nonphysiologically increased in acromegaly, stimulating target tissues directly and indirectly via insulin‐like growth factor type 1 (IGF‐1). Despite GH having anabolic effects on bone growth and renewal, the risk of vertebral fractures is paradoxically increased in acromegaly. We hypothesized that bone tissue compartments were differentially affected by hormonal alterations in active and controlled acromegaly. We aimed to study the effect of sex and gonadal status on long‐term outcome of bone mass and structure to understand the biomechanical competence of bone. We followed 62 patients with newly diagnosed acromegaly longitudinally (median 4.8 years after pituitary surgery) to investigate changes assessed by dual X‐ray absorptiometry (DXA), trabecular bone score (TBS), and hip structure analysis (HSA). At diagnosis, patients had increased bone mineral density (BMD) in most compartments compared with normative data (Z‐scores). Conversely, TBS Z‐score was decreased (Z = −0.64 (SD 1.73), p = 0.028). Following treatment of acromegaly, BMD increased further in compartments containing predominantly trabecular bone, such as the lumbar spine, in eugonadal and male subjects, while compartments with predominantly cortical bone, such as the hip and femoral neck, were unchanged. Total body measurements showed further increase in BMD independent of sex and gonadal status. TBS did not change. HSA revealed a significant decrease in cortical thickness in both sexes independent of gonadal status, whereas the overall size of bone (hip axis length and neck width) did not change over time. In conclusion, patients with acromegaly had increased bone mass and dimensions by DXA. Following normalization of disease activity, BMD increased mainly in compartments rich in trabecular bone, reflecting a closure of the remodeling space. However, HSA revealed a significant decrease in cortical thickness, implying endocortical trabecularization, potentially explaining the increased risk for incident vertebral fractures following treatment. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Sprache
Englisch
Identifikatoren
ISSN: 2473-4039
eISSN: 2473-4039
DOI: 10.1002/jbm4.10787
Titel-ID: cdi_doaj_primary_oai_doaj_org_article_be3c5ca2684440c09e7c9510bb3d666a
Format
–
Schlagworte
Absorptiometry
,
Acromegaly
,
Biochemistry
,
Biomechanics
,
Body measurements
,
Bone growth
,
Bone mass
,
Bone mineral density
,
Bone surgery
,
Bones
,
Cancellous bone
,
Cortical bone
,
Dual energy X-ray absorptiometry
,
DXA
,
Fractures
,
Growth hormone
,
Hip
,
hip structural analysis
,
Immunoassay
,
Insulin-like growth factor I
,
Insulin-like growth factors
,
Patients
,
Pituitary
,
remodeling
,
Software
,
Spine (lumbar)
,
TBS
,
Testosterone
,
trabecular separation
,
Vertebrae
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