Endocrine Abstracts

JOINT2407

Introduction: Both the excess of growth hormone (GH) in acromegaly (Acro) and its deficiency (GHD) may lead to impaired bone metabolism and bone mineral density (BMD) and fragility. However, the exact mechanism remains unclear.

Aim: To evaluate the effects of Acro and GHD treatment on bone metabolism, including bone turnover markers, BMD and bone microarchitecture.

Methods: In this single-center prospective study 26 patients were recruited: 13 (8 males, 5 females) with Acro and 13 (6 males, 7 females) with GHD. Calcium, phosphorus (serum), parathyroid hormone (PTH), 25-hydroxy- and 1,25-dihydroxy-vitamin D and bone turnover markers: serum b-cross laps (Ct-x), Procollagen type I N-terminal propeptide (P1NP), Sclerostin (Scl) and Dikkopff-1 (Dkk-1), and BMD and trabecular bone score (TBS) measured by dual-energy X-ray absorptiometry were assessed baseline and 6 months after adequate treatment (a6m).

Results: Mean age was 50.18±14.45 and 32.17±10.85 yrs. in Acro and GHD group, respectively. In Acro group 7 patients had hypogonadism, whereas in the GHD group 6 patients had multiple pituitary hormonal deficiency. Median baseline GH and IGF-1 levels in Acro were 12.1 µg/l[2.91-74.4] and 652 µg/l(2.86 xULN), respectively. In the GHD group median baseline IGF-1 was 80.4 µg/l(0.95 xLLN). In Acro group a6m of treatment we observed a reduction in serum phosphorus (1.41 vs 1.06 mmol/L). We also observed increase in PTH (29.3 vs 46.4 pg/ml) and decrease in 1,25(OH)2 vitamin D (60.65 vs 54.3 pg/ml). A6m of treatment we noticed an increase in bone turnover markers: Ct-x (26.4 vs 55.7 ng/L), P1NP (290.5 vs 405.5 ng/ml), and Scl (60 vs 68 pg/ml), but a decline in Dkk-1 levels (4198 vs 3873 pg/ml). BMD increased only at the lumbar spine (1.237 vs 1.308 g/cm³). In GHD group there was increase in serum phosphorus (1.03 vs 1,14 mmol/L). A6m of treatment decrease in P1NP (276.8 vs 256.1 ng/ml), and increase in Ct-x (26,8 vs 47,5 ng/ml), Scl (47,6 vs 64,6 pg/ml) and Dkk-1 (3394 vs 4016 pg/ml) was observed. There was no change in BMD and TBS a6m in the GHD group.

Conclusion: We present preliminary results of the study showing the impact of GH changes on bone turnover markers in patients treated for Acro and GHD.