Literature DB >> 2774387

Spinal and peripheral bone mineral densities in acromegaly: the effects of excess growth hormone and hypogonadism.

T Diamond1, L Nery, S Posen.   

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 years). Patients with persistently elevated, plasma somatomedin C concentrations at the end of the study period showed a mean annual increase of 1.5% in forearm measurements during the period of observation, whereas patients with normal concentrations showed a mean annual decrease of 1.0% (P less than 0.01 for the difference between the groups). The percent change in forearm bone mineral content per year (y) was highly correlated with residual somatomedin C activity (x): y = 2.023x - 2.75; r = 0.665.
CONCLUSIONS: Forearm and vertebral bone mineral measurements change in opposite directions in acromegaly. The high forearm values are attributable to the growth-promoting action of growth hormone and somatomedin C, whereas low vertebral values are associated with hypogonadism.

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Year:  1989        PMID: 2774387     DOI: 10.7326/0003-4819-111-7-567

Source DB:  PubMed          Journal:  Ann Intern Med        ISSN: 0003-4819            Impact factor:   25.391


  21 in total

Review 1.  Bone mineral density in acromegaly: does growth hormone excess protect against osteoporosis?

Authors:  I Chiodini; V Trischitta; V Carnevale; A Liuzzi; A Scillitani
Journal:  J Endocrinol Invest       Date:  2001-04       Impact factor: 4.256

2.  Osteopenia occurs in a minority of patients with acromegaly and is predominant in the spine.

Authors:  M J Kayath; J G Vieira
Journal:  Osteoporos Int       Date:  1997       Impact factor: 4.507

3.  Bone mineral density and turnover in patients with acromegaly in relation to sex, disease activity, and gonadal function.

Authors:  Marek Bolanowski; Jacek Daroszewski; Marek Medraś; Beata Zadrozna-Sliwka
Journal:  J Bone Miner Metab       Date:  2006       Impact factor: 2.626

Review 4.  Acromegalic osteopathy.

Authors:  G Mazziotti; F Maffezzoni; S Frara; A Giustina
Journal:  Pituitary       Date:  2017-02       Impact factor: 4.107

5.  Osteoporosis in longstanding acromegaly: characteristic changes of vertebral trabecular architecture and bone matrix composition.

Authors:  J Diebold; B Bätge; H Stein; G Müller-Esch; P K Müller; U Löhrs
Journal:  Virchows Arch A Pathol Anat Histopathol       Date:  1991

6.  Diagnosis and treatment of acromegaly complications.

Authors:  A Giustina; F F Casanueva; F Cavagnini; P Chanson; D Clemmons; L A Frohman; R Gaillard; K Ho; P Jaquet; D L Kleinberg; S W J Lamberts; G Lombardi; M Sheppard; C J Strasburger; M L Vance; J A H Wass; S Melmed
Journal:  J Endocrinol Invest       Date:  2003-12       Impact factor: 4.256

7.  Effect of estrogen deficiency on IGF-I plasma levels: relationship with bone mineral density in perimenopausal women.

Authors:  E Romagnoli; S Minisola; V Carnevale; A Scarda; R Rosso; L Scarnecchia; M T Pacitti; G Mazzuoli
Journal:  Calcif Tissue Int       Date:  1993-07       Impact factor: 4.333

8.  Bone mineral density and circulating cytokines in patients with acromegaly.

Authors:  S Longobardi; C Di Somma; F Di Rella; N Angelillo; D Ferone; A Colao; B Merola; G Lombardi
Journal:  J Endocrinol Invest       Date:  1998-11       Impact factor: 4.256

9.  Bone density and turnover in young adult patients with growth hormone deficiency after 2-year growth hormone replacement according with gender.

Authors:  F Rota; M C Savanelli; L Tauchmanova; S Savastano; G Lombardi; A Colao; C Di Somma
Journal:  J Endocrinol Invest       Date:  2008-02       Impact factor: 4.256

10.  Alterations in body composition in acromegaly.

Authors:  Laurence Katznelson
Journal:  Pituitary       Date:  2009       Impact factor: 4.107

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