Pre-treatment IGF-I concentrations predict radiographic osteoarthritis in acromegalic patients with long-term cured disease
Nienke R Biermasz, Moniek J E Wassenaar, Agatha A van der Klaauw, Alberto M Pereira, Johannes W A Smit, Ferdinand Roelfsema, Ron Wolterbeek, Herman M Kroon, Margreet Kloppenburg & Johannes A Romijn
Objective: To identify factors influencing the development of osteoarthritis during long-term control of acromegaly, focusing on disease specific parameters, growth hormone (GH) and insulin-like growth factor I (IGF-I) concentrations and duration of disease, adjusted for the well-known determinants of primary osteoarthritis.
Design: Follow-up study.
Methods: We studied 67 patients, with adequate biochemical control of acromegaly for a mean of almost 13 years. Study parameters were the results of radiological assessment of the spine, hip, knee, and hand. Osteoarthritis was defined as radiological osteoarthritis using the scoring system developed by Kellgren and Lawrence (K&L). Correlations between potential factors of influence and osteoarthritis were performed by analysis of covariance and adjusted for age, gender and body mass index (BMI).
Results: Patients with pre-treatment IGF-I standard deviation (S.D.) scores in the highest tertile had an almost four-fold increased risk for radiological osteoarthritis of the hip when compared with patients in the lowest tertile. After adjustment for age, gender, BMI, and disease duration, pre-treatment IGF-I S.D. predicted radiographic osteoarthritis in all joint sites. Osteoarthritis was not predicted by other factors including pre-treatment GH levels, type of treatment, and duration of follow-up.
Conclusion: The severity of acromegaly at diagnosis reflected by the height of pretreatment IGF-I concentrations is a predictor of radiographic osteoarthritis in acromegalic patients also after with long-term disease control.