Age, body composition parameters and glycaemic control contribute to trabecular bone score deterioration in acromegaly more than disease activity

Frontiers in Endocrinology

Endocrinology

Marián Mokáň¹  Ingrid Tonhajzerová²  Peter Vaňuga³  Marianna Rončáková³  Ivana Ságová⁴ 

[1] Comenius University Jessenius Faculty of Medicine, 1st Department of Internal Medicine, University Hospital Martin, Martin, Slovakia;Comenius University Jessenius Faculty of Medicine, Department of Physiology, Martin, Slovakia;Department of Endocrinology, National Institute of Endocrinology and Diabetology, Ľubochňa, Slovakia;Department of Endocrinology, National Institute of Endocrinology and Diabetology, Ľubochňa, Slovakia;Comenius University Jessenius Faculty of Medicine, 1st Department of Internal Medicine, University Hospital Martin, Martin, Slovakia;

关键词: acromegaly;    bone mineral density;    dual-energy x-ray absorptiometry;    insulin-like growth factor 1;    trabecular bone score;   

DOI  :  10.3389/fendo.2023.1197725

 received in 2023-03-31, accepted in 2023-06-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionImpairment of bone structure in patients with acromegaly (AP) varies independently of bone mineral density (BMD). Body composition parameters, which are altered in patients with acromegaly, are important determinants of bone strength.PurposeThe aim of this study was to examine BMD and lumbar trabecular bone score (TBS) by dual-energy X-ray absorptiometry (DXA) and to assess its relationship with disease activity, age, glucose metabolism, and body composition parameters.MethodsThis cross-sectional prospective study involved 115 patients with acromegaly (70 F, 45 M) and 78 healthy controls (CON) (53 F, 25 M) matched for age, gender, and BMI. Bone mineral density, TBS and body composition parameters were measured using DXA.ResultsAP presented with lower TBS compared to CON (1.2 ± 0.1 v 1.31 ± 0.1, P< 0.001). No significant correlation was observed between IGF-1/GH levels and TBS. Age, glycated haemoglobin, BMI, waist circumference, fat mass, and lean mass negatively correlated with TBS in both sexes. Multiple linear regression analysis of all these parameters revealed age and waist circumference as independent significant predictors of TBS in AP. We did not find difference in BMD (lumbar and femoral sites) between AP and CON nor between active and controlled AP. We observed negative correlation between age and BMD of the femoral neck and total hip (P < 0.001). Testosterone levels in males, BMI, waist circumference, fat mass, and lean mass positively correlated with BMD in AP, with stronger correlation between lean mass and BMD compared to fat mass.ConclusionPatients with acromegaly have lower TBS than controls, confirming impaired bone microarchitecture in acromegaly regardless of BMD. Age, body composition parameters and glucose metabolism contribute to TBS deterioration in AP more than disease activity itself.

【 授权许可】

Unknown   
Copyright © 2023 Ságová, Mokáň, Tonhajzerová, Rončáková and Vaňuga