OR10-1 VERTEBRAL FRACTURES IN PATIENTS WITH ACROMEGALY: A 3-YEAR PROSPECTIVE STUDY

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: OR10-Osteoporosis
Clinical
Saturday, June 15, 2013: 11:30 AM-1:00 PM
Presentation Start Time: 11:30 AM
Room 121 (Moscone Center)
Gherardo Mazziotti*1, Antonio Bianchi2, Teresa Porcelli3, Marilda Mormando2, Filippo Maffezzoni3, Alessandra Cristiano3, Antonella Giampietro2, Laura De Marinis2 and Andrea Giustina3
1Azienda Ospedaliera Carlo Poma of Mantua, Mantua, Italy, 2Catholic University, School of Medicine, Rome, Italy, 3University of Brescia, Brescia, Italy
Context. Cross-sectional studies showed an elevated prevalence of vertebral fractures in acromegaly. However, no data are available on incident vertebral fractures in this clinical setting.

Objective. To investigate the incidence and risk factors of vertebral fractures in patients with acromegaly.

Design. Three-year prospective study.

Setting. Referral centers.

Subjects. 88 patients with acromegaly  (33 females, 55 males; mean age 50, range 21-88) and 106 control subjects, matched for sex and age (43 females and 63 males, mean age 55 years, range: 33-79), attending out-patient Bone clinics.

Main Measures. Patients and control subjects were evaluated for incidence of vertebral fractures using a quantitative morphometric approach on spine X-ray, which was performed at baseline and after 3 years of follow-up. At the same time-points, patients with acromegaly were also evaluated for bone mineral density (BMD) with DXA at lumbar spine and femoral neck.

Results. After 3-year follow-up, 37 patients with acromegaly (42.0%) and 4 control subjects (3.8%) experienced incident vertebral fractures (p<0.001). The incident of vertebral fractures was significantly higher in patients with active disease as compared to those who were with controlled/cured acromegaly at the study entry (62.5% vs. 25.0%; p<0.001). Risk of incident vertebral fractures was significantly associated with hypogonadism (OR: 6.6 C.I.95% 1.1-43.3; p=0.047), change in femoral neck BMD (OR: 0.80, C.I.95% 0.67-0.96; p=0.02) and prevalent vertebral fractures at the study entry (OR: 6.9, C.I.95% 1.1-43.6; p=0.039) only in patients with controlled/cured acromegaly, whereas in patients with active disease the fracture risk was not influenced by the above clinical factors but it was significantly associated with duration of active acromegaly (OR: 1.6, C.I.95% 1.1-2.3; p=0.01).

Conclusions. This prospective study demonstrates high rate of incident vertebral fractures both in patients with active and controlled acromegaly.

Disclosure: GM: Ad Hoc Consultant, Novartis Pharmaceuticals, Ad Hoc Consultant, Ipsen. AG: Consultant, Ipsen, Consultant, Novartis Pharmaceuticals, Clinical Researcher, Amgen. Nothing to Disclose: AB, TP, MM, FM, AC, AG, LD

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

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