Hoshino Yoshitomo, Hidaka Naoko, Kato Hajime, Koga Minae, Taniguchi Yuki, Kobayashi Hiroshi, Nangaku Masaomi, Makita Noriko, Ito Nobuaki
Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
Department of Orthopedic Surgery, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
Bone Rep. 2022 Oct 17;17:101628. doi: 10.1016/j.bonr.2022.101628. eCollection 2022 Dec.
Some previous case reports have implied a relationship between acromegaly and ossification of the spinal ligaments. However, there have been no reports of a case series exploring the incidence of ossification of the spinal ligaments in patients with acromegaly. To this end, computed tomography (CT) of the spine in 10 consecutive patients with acromegaly was examined in this study. Five out of 10 patients had ossification of the spinal ligaments. Among them, two patients had ossification of the posterior longitudinal ligament (OPLL), which was noticeably higher than the prevalence of OPLL in the general adult population (1.9-4.3 %). Body mass index was significantly higher in the group with spinal ligament ossification ( = 0.03), but there were no significant differences in age, sex, serum phosphate, albumin-adjusted calcium, growth hormone (GH), standard deviation of insulin-like growth factor-1 (IGF-1), or the incidence of diabetes mellitus between the groups with or without ossification of the spinal ligaments. The ossification index (OS index) was used to determine the severity of spinal ligament ossification, and there were no significant correlations between the OS index and GH or IGF-1 ( = 0.51 and 0.75, respectively). This study was the first to report a high prevalence of spinal ossification in patients with acromegaly. In conclusion, this study suggested a possible association between acromegaly and ossification of the spinal ligaments, although the number of patients was insufficient to draw a conclusion. Acromegaly patients should be tested to confirm, or rule out, spinal ossification, and further studies to clarify the underlying mechanism of spinal ossification in acromegaly patients are warranted.
此前一些病例报告暗示了肢端肥大症与脊柱韧带骨化之间的关系。然而，尚无关于探索肢端肥大症患者脊柱韧带骨化发生率的病例系列报道。为此，本研究对10例连续的肢端肥大症患者进行了脊柱计算机断层扫描（CT）检查。10例患者中有5例存在脊柱韧带骨化。其中，2例患者有后纵韧带骨化（OPLL），这一比例明显高于普通成年人群中OPLL的患病率（1.9 - 4.3%）。脊柱韧带骨化组的体重指数显著更高（P = 0.03），但在年龄、性别、血清磷酸盐、白蛋白校正钙、生长激素（GH）、胰岛素样生长因子-1（IGF-1）的标准差或脊柱韧带骨化组与非骨化组之间的糖尿病发生率方面，均无显著差异。骨化指数（OS指数）用于确定脊柱韧带骨化的严重程度，且OS指数与GH或IGF-1之间无显著相关性（分别为P = 0.51和0.75）。本研究首次报道了肢端肥大症患者中脊柱骨化的高患病率。总之，本研究提示肢端肥大症与脊柱韧带骨化之间可能存在关联，尽管患者数量不足以得出结论。应对肢端肥大症患者进行检查以确认或排除脊柱骨化，并且有必要进一步开展研究以阐明肢端肥大症患者脊柱骨化的潜在机制。
