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Related Experiment Video

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Hip Structure Analyses in Acromegaly: Decrease of Cortical Bone Thickness After Treatment: A Longitudinal Cohort

Kristin Godang1, Tove Lekva2, Kjersti Ringvoll Normann1,3

  • 1Section of Specialized Endocrinology Oslo University Hospital Oslo Norway.

JBMR Plus
|December 18, 2019
PubMed
Summary

Acromegaly patients have thicker bones initially, but cortical bone thickness decreases after surgery, potentially increasing fracture risk. This study tracked bone changes in acromegaly versus nonfunctioning pituitary adenoma patients.

Keywords:
ACROMEGALYCORTICAL BONE THICKNESSDXAGH/IGF‐1HIP STRUCTURAL ANALYSIS

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Area of Science:

  • Endocrinology
  • Bone Metabolism
  • Radiology

Background:

  • Long-standing growth hormone (GH) excess in acromegaly leads to skeletal changes, including increased cortical bone thickness (CBT).
  • Despite increased bone dimensions, acromegaly is associated with a high prevalence of vertebral fractures.
  • The longitudinal changes in hip bone geometry following treatment for acromegaly remain incompletely understood.

Purpose of the Study:

  • To assess the changes in hip cortical bone dimensions over one year post-surgery in patients with acromegaly.
  • To compare these changes with those in patients treated for clinically nonfunctioning pituitary adenomas (NFPAs).
  • To investigate the relationship between GH/IGF-1 levels and cortical bone thickness in acromegaly.

Main Methods:

  • A longitudinal cohort study involving 56 acromegaly patients and 47 NFPA patients.
  • Dual-energy X-ray absorptiometry (DXA) and hip structural analysis (HSA) were used to measure cortical bone thickness (CBT) at the femoral neck, calcar, and shaft.
  • Measurements were taken at baseline and 1 year after pituitary surgery, with adjustments for age, gender, and gonadal status.

Main Results:

  • Patients with acromegaly exhibited significantly higher baseline CBT at the femoral neck, calcar, and shaft compared to NFPA patients.
  • GH levels correlated with femoral neck CBT, and IGF-1 levels correlated with calcar CBT in acromegaly patients at baseline.
  • In acromegaly patients, femoral neck CBT decreased by 11.2% and calcar CBT also significantly decreased post-surgery compared to NFPA patients.

Conclusions:

  • The study confirms increased cortical bone thickness in acromegaly patients, as measured by DXA-derived HSA.
  • A significant decline in hip cortical bone thickness occurs in acromegaly patients after pituitary surgery.
  • This post-treatment decrease in bone dimensions may contribute to the elevated fracture risk observed in acromegaly, even after disease control.