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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
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