Acromegaly: effects on bone metabolism and mass.

GH has a pivotal role in maintaining bone mass and metabolism both during childhood and in adult life. This effect depends on a complex interaction between circulating and peripherically produced GH and IGF-I. In vitro data and the use of genetically modified animals have greatly expanded the understanding of regulatory mechanisms underlying the well known skeletal changes featuring acromegalic disease. The present review focuses on the effects of GH excess on bone metabolism and mass in acromegalic patients with particular attention to the influence on bone metabolism as well as arthropathy of factors such as concomitant hypogonadism, gender, age of patients and therapy.