Silva Fabiana Freire, Lima Maria de Lourdes, Pedreira Clarissa Carvalho, Matos Marcos Almeida
Neuroendocrine Unit, Center for Diabetes and Endocrinology of Bahia, Salvador, Bahia, Brazil.
Department of Endocrinology, Roberto Santos General Hospital, Salvador, Bahia, Brazil.
J Bone Miner Metab. 2025 Mar;43(2):123-132. doi: 10.1007/s00774-024-01561-z. Epub 2024 Nov 7.
The purpose of this study was to evaluate the impact of disease activity and gonadal status on bone mineral density (BMD) and turnover markers (BTMs) in individuals with acromegaly.
Subjects underwent laboratory tests for PTH, 25-hydroxyvitamin D, calcium, phosphorus, osteocalcin (OC) and C-telopeptide (CTX-1) and bone densitometry at the lumbar spine (LS), femoral neck (FN) and total hip (TH).
Sixty participants (48.6 ± 11.0 years; 66,7% female) were included in this cross-sectional study. Phosphorus, OC, CTX-1, and LS BMD were greater in the active disease group than in the controlled/cured disease group (P = 0.025, P < 0.001, P = 0.007, and P = 0.016, respectively). When analyzing gonadal status, phosphorus, OC and CTX-1 were greater in the hypogonadal group than in the eugonadal group (P = 0.017, P = 0.015, and P = 0.033, respectively). Patients with hypogonadism had a higher prevalence of reduced bone mass compared to eugonadal patients (44 vs. 17%, P = 0.023).
This study revealed increased levels of phosphorus and BTMs in patients with active acromegaly. In this group, the greater LS BMD values are likely due to the anabolic effects of GH and IGF-1 and/or to the influence of LS arthropathy. Moreover, hypogonadism negatively impacts bone metabolism in acromegaly, leading to elevated BTMs and a higher prevalence of reduced bone mass in individuals affected by both conditions.
本研究旨在评估疾病活动度和性腺状态对肢端肥大症患者骨矿物质密度（BMD）和骨转换标志物（BTMs）的影响。
受试者接受了甲状旁腺激素（PTH）、25-羟基维生素D、钙、磷、骨钙素（OC）和C-末端肽（CTX-1）的实验室检测，并在腰椎（LS）、股骨颈（FN）和全髋关节（TH）进行了骨密度测定。
本横断面研究纳入了60名参与者（年龄48.6±11.0岁；66.7%为女性）。活动期疾病组的磷、OC、CTX-1和LS BMD高于疾病得到控制/治愈组（分别为P = 0.025、P < 0.001、P = 0.007和P = 0.016）。在分析性腺状态时，性腺功能减退组的磷、OC和CTX-1高于性腺功能正常组（分别为P = 0.017、P = 0.015和P = 0.033）。与性腺功能正常的患者相比，性腺功能减退患者骨量减少的患病率更高（44%对17%，P = 0.023）。
本研究揭示了活动期肢端肥大症患者的磷和BTMs水平升高。在该组中，较高的LS BMD值可能归因于生长激素（GH）和胰岛素样生长因子-1（IGF-1）的合成代谢作用和/或LS关节病的影响。此外，性腺功能减退对肢端肥大症患者的骨代谢有负面影响，导致BTMs升高，且在同时患有这两种疾病的个体中骨量减少的患病率更高。
