Endocrine Abstracts

Introduction: Acromegaly is a rare diseaseresulting most commonly from pituitary adenoma. A chronic increase of growth hormone (GH) and insulin-like factor 1 (IGF-1) leads to many systemic complications including osteoporosis and fractures. Radiofrequency echographic multi-spectrometry (REMS) is a new non-ionizing technique to diagnose osteoporosis.

Purpose: The objective of the study was to evaluate bone mineral density (BMD) by REMS in patients with well-controlled and cured acromegaly. The associations between BMD measured by REMS and GH, IGF-1 concentrations and BMD measured by dual energy X-ray absorptiometry (DXA) were investigated in acromegaly patients.

Material and Methods: The study group comprised 33 patients with acromegaly and 24 controls (CG). Based on clinical picture and hormonal evaluation (GH and IGF-1 concentrations) the acromegaly group was divided into two subgroups: well-controlled acromegaly (WCA) – (normal IGF-1 during somatostatin analogues therapy) and cured acromegaly (CA) – (normal IGF-1, patients after successful surgery). Blood samples were obtained from patients with acromegaly to measure concentrations of GH and IGF-1. REMS was performed in all participants, whereas DXA in the acromegaly group only.

Results: There were no significant differences in T-score, Z-score and BMD measured by REMS at lumbar spine (LS) and femoral neck (FN) among the subgroups of patients with acromegaly and controls (WCA, CA and CG). Similarly, we did not observe significant differences in T-score, Z- score and BMD measured by DXA at LS and FN between WCA and CA groups. IGF-1 concentration correlated positively with T-score, Z-score and BMD measured by REMS and DXA at LS and FN in the WCA + CA and WCA groups (P < 0.05). No significant correlations were observed between GH levels and T-score, Z-score and BMD measured by REMS and DXA. Positive correlations between BMD LS assessed by DXA and BMD LS evaluated by REMS were found in WCA + CA and CA groups. There were no significant correlations between BMD FN measured by REMS and DXA.

Conclusion: The present study shows potential utility of REMS assessment of trabecular bone deterioration in acromegaly, as shown by results obtained in lumbar spine. There are no differences in BMD measured by REMS in patients with well-controlled and cured acromegaly. The association between IGF-1 concentration and BMD may suggest an anabolic action of IGF-1 in well-controlled acromegaly.