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Minerva Endocrinologica 2017 Sep 07

DOI: 10.23736/S0391-1977.17.02733-X


lingua: Inglese

Acromegaly and bone

Filippo MAFFEZZONI 1, 2 , Anna M. FORMENTI 1, 2

1 Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy; 2 Endocrinology Unit, Brescia, Italy


INTRODUCTION: Growth hormone (GH) and insulin-like growth factor-I (IGF-1) have pleiotropic effects on the skeleton throughout the lifespan by influencing bone formation and resorption. Despite these positive effects on skeletal metabolism, in presence of GH and IGF-1 excess, bone turnover increases excessively leading to deterioration of bone microarchitecture and high risk of fragility fractures, thereby impairing quality of life.
EVIDENCE ACQUISITION: Coexistent hypogonadism, diabetes mellitus, hypovitaminosis D, hyperparathyroidism and over-replacement with glucocorticoids impair bone framework, however, the effects of acromegaly on bone mineral density (BMD) are still controversial and despite normalization of bone turnover after treatment, the risk for fractures remains increased. As a matter of fact, a major clinical aspect emerging from the studies published so far is the lack of clinical-diagnostic tools able to reliably predict the appearance of fractures in patients with acromegaly occurring even in the presence of normal or low-normal BMD.
EVIDENCE SYNTHESIS: New radiological softwares and clinical devices have been employed in acromegaly patients highlighting a significant impairment of both cortical and cancellous bone.
CONCLUSIONS: In this article, we summarize the pathophysiology, clinical aspects and the new diagnostic tools to better understand bone impairment in acromegaly.

KEY WORDS: Acromegaly - Bone Mineral Density (BMD) - Bone remodelling - Dual-energy X-ray Absorptiometry (DXA) - Bone microarchitecture - Fragility fractures

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Publication History

Article first published online: September 7, 2017
Manuscript accepted: September 4, 2017
Manuscript received: August 31, 2017

Per citare questo articolo

Maffezzoni F, Formenti AM. Acromegaly and bone. Minerva Endocrinol 2017 Sep 07. DOI: 10.23736/S0391-1977.17.02733-X

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