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  • Author: Dusan Pavai x
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Martin Kužma, Peter Vanuga, Ivana Sagova, Dusan Pavai, Peter Jackuliak, Zdenko Killinger, Neil Binkley, Renaud Winzenrieth, Harry Genant and Juraj Payer

Introduction: Impaired bone microarchitecture is involved in vertebral fracture (VF) development among acromegaly (AG) patients.

Aim: Comparison of DXA-derived bone parameters; areal BMD (aBMD), trabecular bone score (TBS) and 3D-SHAPER parameters in AG patients with healthy controls.

Methods: This cross-sectional study of acromegaly patients and a group of healthy controls. In all, single measurement of pituitary axis hormone levels, bone turnover markers (BTMs), aBMD, (total hip [TH] and lumbar spine [LS]), TBS and 3D-SHAPER were performed. All subjects underwent VF assessment using the semi-quantitative approach.

Results: 106 patients with acromegaly (mean age 56,6 years, BMI 30,2 kg/m2) and 104 control subjects (mean age 54,06 years, 28,4 BMI kg/m2) were included. After adjustment for weight, LS aBMD, TBS and TH trabecular volumetric BMD (vBMD) remained lower (p=0.0048, <0.0001 and <0.0001, respectively) while cortical thickness (Cth) at TH and Neck remained thicker (p=0.006) in AG patients compared with controls. The best multivariate model (Model 1) discriminating patients with and without AG included TBS, TH Trabecular vBMD and TH Cth parameters (all p<0.05). 22 VFs (13 AG subjects) were recognized. In these subjects after adjustment for age, FN aBMD, TH cortical sBMD and TH cortical vBMD remained significantly associated with the prevalent VF (OR= 2.69 [1.07-6.78], 2.84 [1.24-6.51] and 2.38 [1.11-5.10] for neck aBMD, TH Cortical sBMD and TH Cortical vBMD respectively. The AUCs were similar for each parameter in this model.

Conclusions: AG patients, regardless of VF presence, have lower trabecular bone quantitative parameters, but those with VFs had decreased cortical density.