Bone mineral density and parameters of bone metabolism in patients with acromegaly

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Abstract
To Assess The Effect Of Chronically Elevated Plasma Growth Hormone (Gh) Levels On Bone Metabolism And Bone Mineral Density (Bmd), 16 Patients (10 Females And 6 Males) With A Mean Age Of 49.1 ± 13.2 Years (Range 33–68) With Active Acromegaly Were Studied And Compared To A Control Group Of 16 Sex- And Age-Matched Subjects. Bmd Of The Lumbar Spine And Two Different Sites Of The Proximal Femur Were Measured By Dual-Energy X-Ray Absorptiometry (Norland Xr-26). In The Acromegalic Patients The Mean Plasma Gh Concentration Was 30.1 ± 11.1 μg/Liter, And The Mean Plasma Somatomedin C (Smc) Concentration Was 6.5 ± 1.5 U/Liter. Mean Serum Osteocalcin (Oc) Levels (14.3 ± 1.1 Versus 7.2 ± 0.4 Ng/Ml, P < 0.001) As Well As The Urinary Hydroxyproline Excretion (Ohp; 8.8 ± 1.4 Versus 2.7 ± 0.3 Mg, P < 0.0001) Were Significantly Higher In The Acromegalic Patients Than In The Control Subjects. In The Acromegalic Patients Bmd Was Significantly Elevated In The Two Examined Regions Of The Proximal Femur, That Is, The Femoral Neck (1.06 ± 0.05 Versus 0.86 ± 0.03 G/Cm2, p < 0.05) and Ward's triangle (0.92 ± 0.06 versus 0.76 ± 0.03 g/cm2, p < 0.02), whereas the BMD of the lumbar spine was not significantly different from that of control subjects. Among the patients with acromegaly a significant positive correlation between serum OC concentrations, on the one hand, and urinary OHP excretion (r = 0.7, p < 0.004) as well as BMD in the proximal femur (r = 0.64, p < 0.007), on the other hand, could be observed. We therefore conclude that in acromegaly bone turnover (formation and resorption) is increased and, moreover, that BMD is significantly enhanced in the proximal femur but not in the lumbar spine.