Bolanowski Marek, Daroszewski Jacek, Medraś Marek, Zadrozna-Sliwka Beata
Department of Endocrinology and Diabetology, Wrocław Medical University, 4 Pasteura Street, 50-367 Wrocław, Poland.
J Bone Miner Metab. 2006;24(1):72-8. doi: 10.1007/s00774-005-0649-9.
Acromegaly is a rare disease caused by growth hormone (GH) hypersecretion. GH and insulin-like growth factor-I (IGF-I) exert anabolic activity in bones. Nevertheless, bone mineral density (BMD) loss is not uncommon in patients with acromegaly. It is assumed to be due to hypogonadism associated with the acromegaly. The aim of the study was to examine BMD at various skeletal sites and bone turnover and to assess the influence of impaired gonadal function and disease activity on BMD and turnover changes in acromegaly. A total of 62 patients were studied (40 women, 22 men). Among the women, 22 had active disease and 18 were cured; 16 women had normal gonadal function, and 24 were hypogonadal. Altogether, 12 men presented with active acromegaly, and 10 were cured; normal gonadal function was found in 10 men, and hypogonadism was diagnosed in 12 men. Controls were 30 healthy subjects. Densitometry using dual-energy X-ray absorptiometry of the lumbar spine, proximal femur, forearm, and total body was carried out. Bone turnover was studied based on serum osteocalcin, C-terminal collagen type 1 crosslinks, and bone alkaline phosphatase concentration. A disadvantageous effect of acromegaly on bone density was associated with hypogonadism in the distal radius (in women), the proximal femur (in men), and the total body (both sexes). An anabolic effect of GH during active acromegaly was present in the proximal femur only in men. We confirmed increased bone turnover in the presence of acromegaly, and these changes were similar regarding the activity of the disease and the gonadal status.
肢端肥大症是一种由生长激素（GH）分泌过多引起的罕见疾病。GH和胰岛素样生长因子-I（IGF-I）对骨骼具有合成代谢活性。然而，肢端肥大症患者骨矿物质密度（BMD）降低并不罕见。这被认为是由于与肢端肥大症相关的性腺功能减退所致。本研究的目的是检查不同骨骼部位的BMD和骨转换情况，并评估性腺功能受损和疾病活动对肢端肥大症患者BMD及转换变化的影响。共研究了62例患者（40名女性，22名男性）。女性患者中，22例疾病活动，18例已治愈；16例女性性腺功能正常；24例性腺功能减退。男性患者中，12例患有活动性肢端肥大症，10例已治愈；10例男性性腺功能正常，12例诊断为性腺功能减退。对照组为30名健康受试者。采用双能X线吸收法对腰椎、股骨近端、前臂和全身进行骨密度测定。基于血清骨钙素、I型胶原C端交联物和骨碱性磷酸酶浓度研究骨转换。肢端肥大症对骨密度的不利影响与桡骨远端（女性）、股骨近端（男性）和全身（男女均有）的性腺功能减退有关。仅在男性的股骨近端，活动性肢端肥大症期间GH具有合成代谢作用。我们证实肢端肥大症患者存在骨转换增加，且这些变化在疾病活动和性腺状态方面相似。
