Kužma Martin, Ságová Ivana, Pavai Dušan, Jackuliak Peter, Killinger Zdenko, Vaňuga Peter, Payer Juraj
Vnitr Lek. 2017 Fall;63(9):589-592.
The impact of acromegaly on bone and the risk of fractures has not been sufficiently investigated. GH hypersecretion stimulates bone turnover, leading to an increase in bone turnover markers. Normal or even increased bone mineral density (BMD) in comparison to healthy controls have been reported, but there are some works where decreased BMD was observed among acromegaly patients with hypogonadism, particularly at lumbar spine. Less pronounced effect of GH overproduction was observed at the femoral neck, as explained by the positive effect of hypersecretion on the cortical bone (due to periosseal ossification). Several studies have documented morphometric vertebral fractures (VF) in 1/3 of acromegaly patients. The major risk factors leading to the development of VF include hypogonadism, diabetes mellitus and previous VF. Because the risk of fractures does not correlate with BMD most of the studies are currently focused on bone quality, bone strength and microstructure.Key words: bone microstructure - growth hormone - IGF1 - vertebral fractures.
肢端肥大症对骨骼的影响以及骨折风险尚未得到充分研究。生长激素分泌过多会刺激骨转换，导致骨转换标志物增加。与健康对照相比，已报告骨矿物质密度（BMD）正常甚至增加，但也有一些研究发现，性腺功能减退的肢端肥大症患者中观察到BMD降低，尤其是在腰椎。在股骨颈观察到生长激素过度分泌的影响不太明显，这可以通过分泌过多对皮质骨的积极作用（由于骨膜骨化）来解释。几项研究记录了三分之一的肢端肥大症患者存在形态计量学椎体骨折（VF）。导致VF发生的主要危险因素包括性腺功能减退、糖尿病和既往VF。由于骨折风险与BMD不相关，目前大多数研究集中在骨质量、骨强度和微观结构上。关键词：骨微观结构 - 生长激素 - IGF1 - 椎体骨折
