Bone microarchitecture and estimated bone strength in men with active acromegaly

Area of Science:

• Endocrinology
• Bone Biology
• Rheumatology

Background:

• Acromegaly and growth hormone deficiency (GHD) are linked to increased fracture risk.
• Limited data exist on cortical bone microarchitecture and strength in these conditions.
• Microfinite element analysis (µFEA) offers advanced bone strength assessment.

Purpose of the Study:

• To compare cortical and trabecular bone microarchitecture and estimated bone strength in men with acromegaly or GHD versus healthy controls.
• To investigate the impact of GH excess and deficiency on bone structure.
• To evaluate the utility of µFEA in assessing bone health in endocrine disorders.

Main Methods:

• Cross-sectional study involving 48 men: 16 with acromegaly, 16 with GHD, and 16 healthy controls.
• Measurements included areal bone mineral density (aBMD), detailed bone microarchitecture, and µFEA.
• Analyses were performed on radius and tibia bone samples.

Main Results:

• No significant differences in aBMD were found across the groups.
• Acromegaly patients showed altered cortical bone (increased area, thickness, pore volume, porosity) and reduced trabecular bone density at the radius.
• Tibia analysis revealed lower trabecular bone density in acromegaly patients, with no cortical changes. GHD patients had no bone microarchitecture deficits.
• Estimated bone strength (compressive strength, failure load) did not differ significantly between groups.

Conclusions:

• Acromegaly significantly alters both cortical and trabecular bone microarchitecture in men.
• Growth hormone excess has distinct effects on cortical versus trabecular bone compartments.
• Standard aBMD measurements may not adequately reflect bone health changes in acromegaly patients.