Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain
Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain.
Eur J Endocrinol. 2016 Feb;174(2):107-14. doi: 10.1530/EJE-15-0931. Epub 2015 Nov 3.
Data on dual energy absorptiometry (DXA)-measured bone mineral density (BMD) at the level of the total hip (TH) and femoral neck (FN) in patients with acromegaly (ACRO) are conflicting. Increase in bone size associated with ACRO may limit the reliability of DXA. Our objective is to evaluate trabecular and cortical volumetric BMD (vBMD) across the proximal femur in ACRO patients.
Cross sectional study in a clinical research center.
Thirty-five ACRO patients (19 males; mean age, 48±7 years; BMI, 27.5±4.4 kg/m(2); 17 with active disease) and 35 age, gender, and BMI-matched controls.
vBMD was assessed by quantitative computed tomography at the level of the TH, FN, trochanter (TR), and intertrochanteric (IT). Trabecular vBMD was lower in both total and active ACRO as compared with controls (P<0.01). Cortical vBMD was lower in ACRO patients (active and controlled) vs controls at both TH and TR sites (P<0.05). These findings were confirmed when only eugonadal patients were analyzed. Both total cross sectional area (CSA) and average cortical thickness (ACT) were greater in ACRO patients vs controls (P<0.05). An inverse association between disease duration and trabecular vBMD at TH (r=-0.42, P=0.023) and IT (r=-0.41, P=0.026) was also found.
Both cortical and trabecular vBMD are reduced at the proximal femur in ACRO patients, regardless of gender, gonadal status, and disease activity. Disease duration is negatively associated with trabecular vBMD at the TH and IT.
关于肢端肥大症（ACRO）患者双能 X 线吸收法（DXA）测量的总髋部（TH）和股骨颈（FN）骨密度（BMD）的数据存在冲突。与 ACRO 相关的骨量增加可能会限制 DXA 的可靠性。我们的目的是评估 ACRO 患者股骨近端的小梁和皮质容积 BMD（vBMD）。
临床研究中心的横断面研究。
35 例 ACRO 患者（男性 19 例；平均年龄 48±7 岁；BMI 27.5±4.4 kg/m²；17 例为活动期疾病）和 35 例年龄、性别和 BMI 匹配的对照组。
通过定量计算机断层扫描在 TH、FN、转子（TR）和转子间（IT）水平评估 vBMD。与对照组相比，总 ACRO 和活动 ACRO 的小梁 vBMD 均较低（P<0.01）。与对照组相比，ACRO 患者（活动期和对照组）的 TH 和 TR 部位的皮质 vBMD 均较低（P<0.05）。当仅分析正常性腺患者时，发现了同样的结果。与对照组相比，ACRO 患者的总横截面积（CSA）和平均皮质厚度（ACT）均较大（P<0.05）。还发现疾病持续时间与 TH（r=-0.42，P=0.023）和 IT（r=-0.41，P=0.026）的小梁 vBMD 呈负相关。
无论性别、性腺状态和疾病活动度如何，ACRO 患者的股骨近端皮质和小梁 vBMD 均降低。TH 和 IT 的小梁 vBMD 与疾病持续时间呈负相关。
