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Understanding the effect of acromegaly on the human skeleton
C Bima1, S Chiloiro1, M Mormando1
1a Pituitary Unit, Department of Endocrinology , Catholic University of "Sacred Heart", School of Medicine , Rome , Italy.
Expert Review of Endocrinology & Metabolism
|July 31, 2018
Summary
Acromegaly patients often develop secondary osteoporosis and fracture risk despite growth hormone's anabolic effects. This review details the skeletal complications, focusing on osteoporosis and fracture risk management in acromegaly.
Area of Science:
- Endocrinology
- Bone Metabolism
- Skeletal Pathophysiology
Background:
- Acromegaly, often caused by Growth Hormone (GH)-secreting pituitary adenomas, involves excess GH and Insulin-like Growth Factor-1 (IGF-1).
- These hormones are key regulators of bone homeostasis, influencing longitudinal bone growth and mass maintenance.
- Paradoxically, many acromegaly patients exhibit secondary osteoporosis and elevated fracture risk despite GH's known anabolic effects.
Purpose of the Study:
- To review the pathophysiology of skeletal complications in acromegaly.
- To outline the diagnosis, clinical presentation, and disease course of these complications.
- To focus on the management of secondary osteoporosis and fracture risk in acromegaly patients.
Main Methods:
- Literature review of pathophysiology, diagnosis, and management of skeletal complications in acromegaly.
- Synthesis of current understanding regarding bone metabolism in acromegaly.
- Analysis of factors contributing to secondary osteoporosis and fracture risk.
Main Results:
- Acromegaly is associated with complex bone changes, including secondary osteoporosis.
- Increased bone turnover and formation do not always translate to improved bone strength.
- Fracture risk is a significant concern in the management of acromegaly.
Conclusions:
- Understanding the pathophysiology of skeletal complications is crucial for effective management.
- Early diagnosis and targeted treatment of secondary osteoporosis are vital in acromegaly.
- Comprehensive management strategies are needed to mitigate fracture risk in acromegaly patients.
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