Endocrine Abstracts (2017) 49 GP38 | DOI: 10.1530/endoabs.49.GP38

Decreased trabecular bone score but not bone mineral density in patients with acromegaly and concurrent hypogonadism: cross-sectional study with healthy controls

Martin Kužma1, Dušan Pavai2, Ivana Ságová3, Zdenko Killinger1, Peter Jackuliak1, Anton Vaňuga2, Peter Vaňuga2 & Juraj Payer1


1Comenius University Faculty of Medicine, Fifth Department of Internal Medicine, University Hospital Bratislava, Bratislava, Slovakia; 2National Institute of Endocrinology and Diabetology, Lubochna, Slovakia; 3Comenius University Jessenius Faculty of Medicine, First Department of Internal Medicine, University Hospital, Martin, Slovakia.


Introduction: Acromegaly is associated with higher prevalence of vertebral fractures (VFx) and bone microarchitecture potentially play a role in fracture development. Trabecular bone score (TBS), a novel indicator of bone microstructure could provide additional information.

Objectives: Assessment of BMD, TBS and bone turnover markers (BTM) in acromegaly patients in comparison to healthy controls with regard to gender, hypogonadism and disease activity.

Patients and methods: A cross-sectional study of acromegaly patients with age-, gender- and BMI-matched healthy controls was conducted. Study group consisted from all acromegaly patients (regardless age, gender, disease duration or activity) which came for follow-up visit during period 6/2016 – 12/2016 and the control group consisted of healthy subjects. In all subjects a single measurements of all pituitary axis hormones levels, BTM, BMD of total hip (TH) and lumbar spine (LS) and TBS was performed. N-terminal type 1 procollagen (P1NP) - marker of bone formation and C-terminal telopeptide (CTx) –marker of bone resorption were analyzed.

Results: Thirty Seven acromegaly patients (12 males/25 females with mean age 56.7 years, mean BMI 29.8 kg/m2) and 27 of control group subjects (seven males/20 females with mean age 59.5 years, mean BMI 30.9 kg/m2) were included. TBS was significantly lower in patients in comparison to controls (1.16 vs 1.22; P<0.05), but no BMD and BTM difference was observed. Hypogonadal patients had lower TBS in comparison to patients without hypogonadism (TBS 1.13 vs 1.20; P<0.05) and no BMD difference. BTM were increased in hypogonadal patients (CTx 0.67 vs 0.38 ng/ml; P1NP 75.5 vs 47.5 ng/ml; both P<0.05). No difference in TBS, LS BMD and BTM with regard to gender was observed.

Conclusion: This study indicates that patients with acromegaly, especially those with hypogonadism, despite unchanged BMD, may have impaired trabecular bone microstructure, which can lead to increased prevalence of fractures.

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