ECE2016 Eposter Presentations Pituitary - Clinical (83 abstracts)
Radiological vertebral fractures in patients with acromegaly treated with L-thyroxine
Filippo Maffezzoni 1 , Stefano Frara 1 , Anna Maria Formenti 1 , Monica Mezzone 1 , Luigi Cerri 1 , Teresa Porcelli 1 , Francesco Doglietto 3 , Roberto Maroldi 2 , Gherardo Mazziotti 1 & Andrea Giustina 1
1Endocrinology, Brescia, Italy; 2Radiology, Brescia, Italy; 3Neurosurgery, Brescia, Italy.
Acromegaly is associated with skeletal fragility and high risk of vertebral fractures (VFs), but the determinants of such a risk are still under investigation and it is not clear whether replacement therapies of coexistent hypopituitarism may influence prevalence and incidence of VFs. In this cross sectional study, fourty acromegaly patients (24 M, 16 F; median age, 57 years; range, 25–72), 20 with active disease, were evaluated for the effects of replacement therapy of central hypothyroidism on radiological VFs. Seven patients had glucocorticoid deficiency, 14 had hypothyroidism and 25 were hypogonadal (5 men and one pre-menopausal woman were on replacement therapy). Patients were evaluated for morphometrical VFs and for bone mineral density (BMD) with DXA at lumbar spine, total hip and femoral neck. VFs were found in 15 patients (37.5%), without significant difference between patients with hypothyroidism and those without hypothyroidism (50.0% vs. 30.8%; P=0.23). Among patients with hypothyroidism, those with VFs showed higher serum FT4 (13.0 pg/ml, range: 7–17 vs. 9.7 pg/ml, range: 9–16; P=0.02) and daily levo-thyroxine (L-T4) dose (1.43 μg/kg, range: 1.29–1.58 vs. 0.92 μg/kg, range: 0.7–1.1; P=0.009). Serum FT4 and daily dose of L-T4 were not significantly associated with BMD at lumbar spine, femoral neck and total hip. VFs were also significantly associated with age of patients (odds ratio: 1.16; C.I. 95% 1.05–1.3), untreated hypogonadism (odds ratio: 5.8; C.I. 95% 1.4–24.2) and duration of active acromegaly (odds ratio: 1.21; C.I. 95% 1.01–1.4), whereas no significant associations were found with treated hypoadrenalism, sex, BMI and BMD at either skeletal sites. In conclusion, this study provides a first evidence that a relative overtreatment of central hypothyroidism may influence the fracture risk in patients with acromegaly, consistently with the pathophysiological hypothesis that thyroid hormone excess and GH hypersecretion may have additive negative effects on bone remodeling and skeletal health.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more