ECE2015 Eposter Presentations Pituitary: clinical (121 abstracts)
Increased serum levels of the Wnt antagonist Dicckopf-1 (DKK1) and impaired trabecular bone mineral density using QCT scan in acromegalic patients
Elena Valassi 1 , Iris Crespo 1 , Anna Aulinas 1 , Eulalia Urgell 2 , Jorge Malouf 3 , Jaume Llauger 4 , Ana Maria Marin 3 , Betina Biagetti 5 & Susan M Webb 1
1II-B Sant Pau and Department of Internal Medicine/Endocrinology, Hospital Sant Pau, UAB and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII, Barcelona, Spain; 2Department of Biochemistry, Hospital Sant Pau, Barcelona, Spain; 3Department of Internal Medicine, Mineral Metabolism Unit, Hospital Sant Pau, Barcelona, Spain; 4Department of Radiology, Hospital Sant Pau, Barcelona, Spain; 5Department of Endocrinology, Hospital Vall d’Hebron, UAB, Barcelona, Spain.
Introduction: Acromegaly is associated with increased bone turnover and skeletal fragility. Although the GH/IGF1 system plays an important role in bone homeostasis, effects of GH excess on the Wnt signalling pathway are to be determined. Bone quantitative CT (QCT) provides a volumetric, tridimensional measure of bone mass at the trabecular and cortical level.
Aim: i) To compare volumetric bone density (vBMD) using QCT in patients with acromegaly vs gender-, age-, and BMI-matched controls; ii) to correlate it with the levels of Wnt antagonists, dickkopf factor-1 (DKK1) and sclerostin (SOST), in the same subjects.
Methods: Thirty-one acromegalic patients (17 (55%) men; 18 (58%) with active disease; mean age 48.2±7.5 years (range 28–65 years)) and thirty-two age-, gender- and BMI-matched controls underwent QCT scan using Mindways Software. Serum concentrations of DKK1, SOST, ß-crosslaps, procollagen type-1 amino-terminal propeptid (P1NP) and osteocalcin were also measured.
Results: vBMD of cortical total hip (CTH vBMD) and trabecular total hip (TTH vBMD) were lower in acromegaly than controls (CTH vBMD, 776±199.4 vs 937±346.4 mg/cm3; P<0.05 and TTH vBMD, 121.4±20.6 vs 142.8±22.8; P<0.01). P1NP levels were lower (41.7±20.5 vs 51±21.2 ng/ml, P<0.05), while DKK1 levels were higher (33.7±12.9 vs 26±14.8 pmol/l, P<0.05) in acromegaly patients compared to controls. No intergroup difference in ß-crosslaps, osteocalcin and SOST levels was observed. A negative correlation between DKK1 and TTH vBMD (r=−0.382, P<0.01) was observed. A positive correlation between P1NP, ß-crosslaps, and SOST with CTH vBMD (r=0.34, r=0.27, r=0.26, respectively, P<0.05) was also observed. After multiple regression analysis, DKK1 and disease duration were independent, negative predictors of TTH vBMD (R2=0.335, P<0.05), whereas female gender was an independent, positive predictor of CTH vBMD (R2=0.156, P<0.05).
Conclusions: Acromegaly patients exhibit low vBMD on QCT. The Wnt signalling antagonist DKK1 may contribute to the skeletal fragility described in acromegaly.
Supported by grants from FIS ISCIII PI 11/00001 and Fundación Merck Serono 2012.
Disclosure: Supported by grants from FIS ISCIII PI 11/00001 and Fundación Merck Serono 2012.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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