Hip Structure Analyses in Acromegaly: Decrease of Cortical Bone Thickness After Treatment: A Longitudinal Cohort Study

Kristin Godang; Tove Lekva; Kjersti Ringvoll Normann; Nicoleta Cristina Olarescu; Kristin Astrid Berland Øystese; Anders Kolnes; Thor Ueland; Jens Bollerslev; Ansgar Heck

doi:10.1002/jbm4.10240

Hip Structure Analyses in Acromegaly: Decrease of Cortical Bone Thickness After Treatment: A Longitudinal Cohort Study

JBMR Plus. 2019 Oct 23;3(12):e10240. doi: 10.1002/jbm4.10240. eCollection 2019 Dec.

Authors

Kristin Godang¹, Tove Lekva², Kjersti Ringvoll Normann^{1

3}, Nicoleta Cristina Olarescu¹, Kristin Astrid Berland Øystese¹, Anders Kolnes¹, Thor Ueland^{2

3

4}, Jens Bollerslev^{1

3}, Ansgar Heck^{1

3}

Affiliations

¹ Section of Specialized Endocrinology Oslo University Hospital Oslo Norway.
² Research Institute of Internal Medicine Oslo University Hospital Oslo Norway.
³ Faculty of Medicine University of Oslo Oslo Norway.
⁴ KG Jebsen TREC University of Tromsø Tromsø Norway.

Abstract

Long-standing growth hormone (GH) excess causes the skeletal clinical signs of acromegaly with typical changes in bone geometry, including increased cortical bone thickness (CBT). However, a high prevalence and incidence of vertebral fractures has been reported. The aim of this study was to assess the course of cortical bone dimensions in the hip by comparing patients with acromegaly and clinically nonfunctioning pituitary adenomas (NFPAs) at baseline and 1 year after pituitary surgery (1-year PO) in a longitudinal cohort study. DXA was performed in patients with acromegaly (n = 56) and NFPA (n = 47). CBT in the femoral neck (CBTneck), calcar (CBTcalcar), and shaft (CBTshaft) were determined by hip structural analysis (HSA). CBT at baseline and the change to 1-year PO were compared. Test results were adjusted for differences in gender distribution, age, and gonadal status. Cortical thickness analyses showed higher values [mm] at baseline in patients with acromegaly compared with NFPA: CBTneck median [25th; 75th] 6.2 [4.7; 8.0] versus 5.1 [4.1; 6.4] (p = 0.006), CBTcalcar 4.8 [4.2, 5.7] versus 4.0 [3.2, 4.5] (p < 0.001), CBTshaft 6.2 [5.1, 7.2] versus 5.2 [4.6, 6.0], (p = 0.003). In acromegaly, GH was correlated with CBTneck (r = 0.31, p = 0.020), whereas IGF-1 was correlated with CBTcalcar (r = 0.39, p = 0.003) at baseline. In acromegaly, CBTneck decreased by 11.2%, p = 0.002 during follow-up. Finally, the decrease in CBTneck and CBTcalcar in acromegaly was significant compared with NFPA (p = 0.023 and p = 0.017, respectively). Previous observations of increased CBT in acromegaly were confirmed with DXA-derived HSA in a large, well-defined cohort. The decline in CBT in acromegaly could contribute to the increased fracture risk in acromegaly despite increased bone dimensions and disease control. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

Keywords: ACROMEGALYCORTICAL BONE THICKNESS; DXA; GH/IGF‐1; HIP STRUCTURAL ANALYSIS.