Miriam Cellini1, Emilia Biamonte1, Massimiliano Mazza1, Nicoletta Trenti2, Pasquala Ragucci2, Davide Milani3, Emanuele Ferrante4, Zefferino Rossini3, Elisabetta Lavezzi1, Elisa Sala4, Giovanna Mantovani4,5, Maura Arosio4,5, Maurizio Fornari3, Luca Balzarini2, Andrea G Lania6,7, Gherardo Mazziotti1,8. 1. Endocrinology, Diabetology and Andrology Unit - Metabolic Bone Diseases and Osteoporosis Section, Milan, Italy. 2. Department of Radiology, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy. 3. Department of Neurosurgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy. 4. Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 5. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 6. Endocrinology, Diabetology and Andrology Unit - Metabolic Bone Diseases and Osteoporosis Section, Milan, Italy, andrea.lania@hunimed.eu. 7. Department of Biomedical Sciences, Humanitas University, Milan, Italy, andrea.lania@hunimed.eu. 8. Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Abstract
INTRODUCTION: Acromegaly is commonly complicated by arthropathy and skeletal fragility with high risk of vertebral fractures (VFs). OBJECTIVE: This study aimed to assess whether VFs may be associated with sagittal spine deformities, arthropathy, impaired quality of life (QoL), pain, and disability. METHODS: Thirty-eight patients with acromegaly (median age: 55 years, 20 males) and 38 matched control subjects were evaluated by a low-dose sagittal and coronal planes, X-ray imaging system (EOS®-2D/3D) for morphometric VFs, radiological signs of spine arthropathy, and spine deformities (Cobb thoracic index ≥40°, pelvic incidence minus lumbar lordosis ≥10°, pelvic tilt >20°, and sagittal vertical axis ≥4 cm) determining sagittal spine imbalance. Acromegalic patients were also evaluated by questionnaires for QoL (Acromegaly QoL Questionnaire [AcroQoL] and Short Form-36 [SF-36]) and pain and disability (Western Ontario and McMaster University [WOMAC]). RESULTS: Acromegalic patients showed higher prevalence of thoracic hyperkyphosis (i.e., Cobb thoracic index ≥40°; p = 0.04) and pelvic tilt >20° (p = 0.02) than control subjects. VFs were found in 34.2% of acromegalic patients (p = 0.003 vs. control subjects), in relationship with higher prevalence of hyperkyphosis (p = 0.03), pelvic tilt >20° (p = 0.04), sagittal vertical axis ≥4 cm (p = 0.03), and moderate/severe subchondral degeneration (p = 0.01). Moreover, patients with VFs had lower AcroQoL general health (p = 0.007) and SF-36 general health (p = 0.002) scores and higher WOMAC pain (p = 0.003) and global (p = 0.009) scores than patients who did not fracture. CONCLUSIONS: In acromegaly, VFs may be associated with spine deformities and sagittal imbalance, spine arthropathy, impaired QoL, and disability.
INTRODUCTION: Acromegaly is commonly complicated by arthropathy and skeletal fragility with high risk of vertebral fractures (VFs). OBJECTIVE: This study aimed to assess whether VFs may be associated with sagittal spine deformities, arthropathy, impaired quality of life (QoL), pain, and disability. METHODS: Thirty-eight patients with acromegaly (median age: 55 years, 20 males) and 38 matched control subjects were evaluated by a low-dose sagittal and coronal planes, X-ray imaging system (EOS®-2D/3D) for morphometric VFs, radiological signs of spine arthropathy, and spine deformities (Cobb thoracic index ≥40°, pelvic incidence minus lumbar lordosis ≥10°, pelvic tilt >20°, and sagittal vertical axis ≥4 cm) determining sagittal spine imbalance. Acromegalic patients were also evaluated by questionnaires for QoL (Acromegaly QoL Questionnaire [AcroQoL] and Short Form-36 [SF-36]) and pain and disability (Western Ontario and McMaster University [WOMAC]). RESULTS: Acromegalic patients showed higher prevalence of thoracic hyperkyphosis (i.e., Cobb thoracic index ≥40°; p = 0.04) and pelvic tilt >20° (p = 0.02) than control subjects. VFs were found in 34.2% of acromegalic patients (p = 0.003 vs. control subjects), in relationship with higher prevalence of hyperkyphosis (p = 0.03), pelvic tilt >20° (p = 0.04), sagittal vertical axis ≥4 cm (p = 0.03), and moderate/severe subchondral degeneration (p = 0.01). Moreover, patients with VFs had lower AcroQoL general health (p = 0.007) and SF-36 general health (p = 0.002) scores and higher WOMAC pain (p = 0.003) and global (p = 0.009) scores than patients who did not fracture. CONCLUSIONS: In acromegaly, VFs may be associated with spine deformities and sagittal imbalance, spine arthropathy, impaired QoL, and disability.
Authors: E Vitali; E Palagano; M L Schiavone; G Mantovani; C Sobacchi; G Mazziotti; A Lania Journal: J Endocrinol Invest Date: 2022-01-12 Impact factor: 4.256
Authors: E Biamonte; R Levi; F Carrone; W Vena; A Brunetti; M Battaglia; F Garoli; G Savini; M Riva; A Ortolina; M Tomei; G Angelotti; M E Laino; V Savevski; M Mollura; M Fornari; R Barbieri; A G Lania; M Grimaldi; L S Politi; G Mazziotti Journal: J Endocrinol Invest Date: 2022-06-25 Impact factor: 5.467
Authors: Sabrina Chiloiro; Antonella Giampietro; Irene Gagliardi; Marta Bondanelli; Miriam Veleno; Maria Rosaria Ambrosio; Maria Chiara Zatelli; Alfredo Pontecorvi; Andrea Giustina; Laura De Marinis; Antonio Bianchi Journal: Pituitary Date: 2022-08-03 Impact factor: 3.599