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Related Experiment Videos

Acromegalic axial arthropathy: a clinical case-control study.

Raffaele Scarpa1, Davide De Brasi, Rosario Pivonello

  • 1Department of Clinical Medicine, Section of Rheumatology, Federico II University of Naples, 80131 Naples, Italy.

The Journal of Clinical Endocrinology and Metabolism
|February 7, 2004
PubMed
Summary

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Acromegaly significantly impacts the axial skeleton, causing reduced spinal mobility and altered spine morphology. Early diagnosis is crucial to mitigate severe spine abnormalities and prevent conditions like diffuse idiopathic skeletal hyperostosis (DISH).

Area of Science:

  • Endocrinology and Metabolism
  • Rheumatology and Musculoskeletal Diseases
  • Radiology and Imaging

Background:

  • Arthropathy is a primary cause of morbidity in acromegaly patients.
  • Acromegaly, characterized by excess growth hormone (GH) and insulin-like growth factor I (IGF-I), is known to affect joints.
  • The specific impact of acromegaly on the axial skeleton requires further investigation.

Purpose of the Study:

  • To investigate the prevalence of axial arthropathy in patients with active acromegaly.
  • To assess the association between spinal involvement and hormonal parameters in acromegaly.
  • To evaluate the correlation between disease duration and the severity of spinal abnormalities.

Main Methods:

  • A prospective case-control study involving 54 acromegaly patients and 54 matched healthy controls.

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  • Data collection included questionnaires on symptoms, rheumatological examinations, axial radiological studies, and hormonal level measurements (GH, IGF-I, insulin, glucose).
  • Statistical analysis used chi-squared tests to compare prevalence and correlations were assessed using appropriate statistical methods.

    • Main Results:

    • Axial arthropathy was significantly more prevalent in acromegaly patients (52%) compared to controls (22%).
    • Reduced spinal mobility, altered spinal profiles, and increased L2 vertebra diameters were significantly higher in acromegaly patients.
    • Features of diffuse idiopathic skeletal hyperostosis (DISH) were observed in 20% of acromegaly patients but none of the controls.
    • Disease duration correlated with vertebral body height and intervertebral space height.
    • DISH severity correlated with basal and peak glucose levels.

    Conclusions:

    • Chronic GH and IGF-I excess in acromegaly leads to significant axial skeleton alterations, including reduced mobility and morphology changes.
    • The development of DISH is associated with acromegaly and glucose metabolism.
    • Early diagnosis and management of acromegaly are essential to reduce the severity of spine abnormalities, particularly in patients with longer disease duration.