Endocrine Abstracts

Introduction: In previous studies, it was noted that increased serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) lead to the increased vertebral fractures risk in patients with acromegaly. This may be explained by the altered quality of bone rather than bone mineral density (BMD) loss. Trabecular bone score (TBS) is an easily available tool to obtain some surrogate information on bone microarchitecture from a routine DXA.

Objective: To evaluate trabecular bone score (TBS) and standard dual-energy X-ray absorptiometry (DXA) measurements in patients with acromegaly (compared to the healthy controls).

Methods: 32 patients with confirmed active acromegaly and 35 healthy volunteers were enrolled into the study. Standard DXA with simultaneous calculation of TBS L1-L4 was performed using GE iDXA, TBS iNsight software v2.1 (Medimaps, Merignac, France). Serum insulin-like growth factor-1 (IGF-1) in patients with acromegaly was measured by the immunochemiluminescence assay, reference range (60–280 ng/ml).

Results: The groups were matched by sex (in total 21 men and 46 women) P=0.657; age 45.1 (95% CI 41.3–48.9) in patients with acromegaly and 44.7 (95% CI 42.7–46.7) P=0.225 and BMI 28.5 (95% CI 27.1–29.9) kg/m² in patients with acromegaly vs 26.7 (95% CI 25.3–28.1) kg/m² P=0.065. Mean IGF-1 level in patients with acromegaly was 703.79 ng/ml (95% CI 595.37–812.20). In patients with acromegaly there were not revealed significant differences in any DXA measurements compared to the control group: BMD L1-L4 1.162 g/sm² (95% CI 1.100–1.225) vs 1.221 g/sm² (95% CI 1.149–1.293); BMD T-score L1-L4 −0.28 S.D. (95% CI −0.79 to 0.23) vs 0.24 S.D. (95% CI −0.36 to 0.83); BMD Z-score L1-L4 −0.29 S.D. (95% CI −0.75 to 0.18) vs 0.12 S.D. (95% CI −0.40 to 0.63) (P=0.221, 0.192 and 0.245 respectively). TBS L1-L4 in patients with acromegaly was 1.408 (95% CI 1.358–1.458) vs 1.463 (95% CI 1.424–1.501) in controls (P=0.080). Statistically significant correlation between IGF-1 and TBS L1-L4 was not identified (as well as between IGF-1 and BMD, T- and Z-scores): r=0.313, 0.296, 0.274 and 0.092 respectively (P=0.098, 0.119, 0.150 and 0.635 respectively).

Conclusion: Acromegaly does not affect TBS or BMD in the value to be diagnostics in the individual subjects or in a small patient groups.

Funding: MD-3204.2017.7