Acromegaly has a negative influence on trabecular bone, but not on cortical bone, as assessed by high-resolution peripheral quantitative computed tomography

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 130-162-Neuroendocrinology
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-150
Miguel Madeira1, Leonardo Vieira Neto*2, Francisco de Paula Paranhos Neto1, Inayá Corrêa Barbosa Lima1, Laura Maria Carvalho Mendonça1, Monica Gadelha3 and Maria Lucia Fleiuss Farias1
1Hospital Universitário Clementino Fraga Filho / Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, 2FED UNIV OF RIO DE JANEIRO, Rio de Janeiro, Brazil, 3Fed Univ of Rio de Janeiro, Rio De Janeiro-RJ, Brazil
Introduction: Acromegaly is one of the causes of secondary osteoporosis, although studies of bone mineral density (BMD) have yielded conflicting results and none of them have evaluated the bone properties.

Objectives and Patients: In a cohort of 82 acromegalic patients, correlate BMD and bone microarchitecture, using dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT), with the presence of type 2 diabetes mellitus (T2DM), disease activity and gonadal status. To compare these bone parameters between 45 eugonadal acromegalic patients and 45 healthy controls.

Results: Acromegalic patients with T2DM had lower trabecular density (Dtrab) and trabecular bone volume to tissue volume (BV/TV) ratio in the distal tibia.  Patients with active acromegaly exhibited a higher BMD and T-score in the lumbar spine (p=0.02 for both) and a higher cortical density in the distal tibia when compared to those with controlled acromegaly (p=0.001). After multiple linear regression (including age, presence of T2DM, acromegaly activity and gonadal status), eugonadism remained the main determinant of bone parameters. The 45 acromegalic patients with eugonadism were compared with 45 age- and sex-matched controls and exhibited lower trabecular densities and impaired microstructures.

Conclusions: Acromegaly appears to have a deleterious effect on trabecular bone microarchitecture and that, in this specific population, the gonadal status might be more important than T2DM or acromegaly activity in determining bone health. HR-pQCT seems promising for evaluating acromegalic bone properties and for addressing the limitations posed by DXA.

Nothing to Disclose: MM, LVN, FDPPN, ICBL, LMCM, MG, MLFF

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