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05.10.2016

Acromegalic osteopathy

verfasst von: G. Mazziotti, F. Maffezzoni, S. Frara, A. Giustina

Erschienen in: Pituitary | Ausgabe 1/2017

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Abstract

Acromegalic osteopathy is an emerging complication of acromegaly characterized by increase in bone turnover, deterioration in bone microarchitecture and high risk of vertebral fractures. Vertebral fractures, as diagnosed by a radiological and morphometric approach, occur in about one-third of acromegaly patients in close relationship with duration of active disease. However, the prediction of vertebral fractures in this clinical setting is still a matter of uncertainty, since the pathogenesis of acromegalic osteopathy is multifactorial and fractures may occur even in presence of normal bone mineral density. In this narrative article, we summarize the pathophysiology and clinical aspects of acromegalic osteopathy.

Giustina A, Mazziotti G, Canalis E (2008) Growth hormone, insulin-like growth factors, and the skeleton. Endocr Rev 29:535–559CrossRefPubMedPubMedCentral

Mazziotti G, Bianchi A, Bonadonna S, Nuzzo M, Cimino V, Fusco A, De Marinis L, Giustina A (2006) Increased prevalence of radiological spinal deformities in adult patients with GH deficiency: influence of GH replacement therapy. J Bone Miner Res 21:520–528CrossRefPubMed

Wuster C, Abs R, Bengtsson BA, Bennmarker H, Feldt-Rasmussen U, Hernberg-Ståhl E, Monson JP, Westberg B, Wilton P, KIMS Study Group and the KIMS International Board. Pharmacia and Upjohn International Metabolic Database (2001) The influence of growth hormone deficiency, growth hormone replacement therapy, and other aspects of hypopituitarism on fracture rate and bone mineral density. J Bone Miner Res 16:398–405CrossRefPubMed

Giustina A, Mazziotti G (2015) Growth hormone replacement therapy and fracture risk. Lancet Diabetes Endocrinol 3:307–308CrossRefPubMed

Mazziotti G, Doga M, Frara S, Maffezzoni F, Porcelli T, Cerri L, Maroldi R, Giustina A (2016) Incidence of morphometric vertebral fractures in adult patients with growth hormone deficiency. Endocrine 52:103–110CrossRefPubMed

Albright F, Reifenstein EC (1948) The Parathyroid Glands and Metabolic Bone Disease. Williams and Wilkins, Baltimore

Mazziotti G, Chiavistelli S, Giustina A (2015) Pituitary diseases and bone. Endocrinol Metab Clin North Am 44:171–180CrossRefPubMed

Halse J, Melsen F, Mosekilde L (1981) Iliac crest bone mass and remodeling in acromegaly. Acta Endocrinol 97:18–22PubMed

Riggs L, Randall RV, Wanner HW, Jowsey J, Kelly PJ, Singh M (1972) The nature of metabolic bone disorder in acromegaly. J Clin Endocrinol Metab 34:911–918CrossRefPubMed

10.

Kayath MJ, Vieira JG (1997) Osteopenia occurs in a minority of patients with acromegaly and is predominant in the spine. Osteoporos Int 7:226–230CrossRefPubMed

11.

Vestergaard P, Mosekilde L (2004) Fracture risk is decreased in acromegaly–a potential beneficial effect of growth hormone. Osteoporos Int 15:155–159CrossRefPubMed

12.

Madeira M, Neto LV, de Paula Paranhos Neto F, Barbosa Lima IC, Carvalho de Mendonça LM, Gadelha MR, Fleiuss de Farias ML (2013) Acromegaly has a negative influence on trabecular bone, but not on cortical bone, as assessed by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 98:1734–1741CrossRefPubMed

13.

Maffezzoni F, Maddalo M, Frara S, Mezzone M, Zorza I, Baruffaldi F, Doglietto F, Mazziotti G, Maroldi R, Giustina A (2016) Cone beam tomography analysis of bone microarchitecture in patients with acromegaly and vertebral fractures. Endocrine. doi:10.1007/s12020-016-1078-3

14.

Mazziotti G, Biagioli E, Maffezzoni F, Spinello M, Serra V, Maroldi R, Floriani I, Giustina A (2015) Bone turnover, bone mineral density, and fracture risk in acromegaly: a meta-analysis. J Clin Endocrinol Metab 100:384–394CrossRefPubMed

15.

Canalis E, Giustina A, Bilezikian JP (2007) Mechanisms of anabolic therapies for osteoporosis. N Engl J Med 357:905–916CrossRefPubMed

16.

Mazziotti G, Bilezikian J, Canalis E, Cocchi D, Giustina A (2012) New understanding and treatments for osteoporosis. Endocrine 41:58–69CrossRefPubMed

17.

Kassem M, Blum W, Ristelli J, Mosekilde L, Eriksen EF (1993) Growth hormone stimulates proliferation and differentiation of normal human osteoblast-like cells in vitro. Calcif Tissue Int 52:222–226CrossRefPubMed

18.

DiGirolamo DJ, Mukherjee A, Fulzele K, Gan Y, Cao X, Frank SJ, Clemens TL (2007) Mode of growth hormone action in osteoblasts. J Biol Chem 282:31666–31674CrossRefPubMed

19.

Stĕpán J, Marek J, Havránek T, Dolezal V, Pacovský V (1979) Bone isoenzyme of serum alkaline phosphatase in acromegaly. Clin Chim Acta 93:355–363CrossRefPubMed

20.

Scillitani A, Chiodini I, Carnevale V, Giannatempo GM, Frusciante V, Villella M, Pileri M, Guglielmi G, Di Giorgio A, Modoni S, Fusilli S, Di Cerbo A, Liuzzi A (1997) Skeletal involvement in female acromegalic subjects: the effects of growth hormone excess in amenorrheal and menstruating patients. J Bone Miner Res 12:1729–1736CrossRefPubMed

21.

Ueland T, Bollerslev J, Godang K, Müller F, Frøland SS, Aukrust P (2001) Increased serum osteoprotegerin in disorders characterized by persistent immune activation or glucocorticoid excess–possible role in bone homeostasis. Eur J Endocrinol 145:685–690CrossRefPubMed

22.

Claessen KM, Mazziotti G, Biermasz NR, Giustina A (2016) Bone and Joint Disorders in Acromegaly. Neuroendocrinology 103:86–95CrossRefPubMed

23.

Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A, McClung M, Morris HA, Silverman S, Trenti T, Wahl DA, Cooper C, Kanis JA (2011) Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 22:391–420CrossRefPubMed

24.

Kamenický P, Mazziotti G, Lombès M, Giustina A, Chanson P (2014) Growth hormone, insulin-like growth factor-1, and the kidney: pathophysiological and clinical implications. Endocr Rev 35:234–281CrossRefPubMed

25.

Halupczok-Żyła J, Jawiarczyk-Przybyłowska A, Bolanowski M (2015) Patients with active acromegaly are at righ risk of 25(OH)D deficiency. Front Endocrinol 6:89

26.

Ajmal A, Haghshenas A, Attarian S, Barake M, Tritos NA, Klibanski A, Miller KK, Nachtigall LB (2014) The effect of somatostatin analogs on vitamin D and calcium concentrations in patients with acromegaly. Pituitary 17:366–373CrossRefPubMed

27.

Mazziotti G, Maffezzoni F, Giustina A (2016) Vitamin D-binding protein: one more piece in the puzzle of acromegalic osteopathy? Endocrine 52:183–186CrossRefPubMed

28.

Altinova AE, Ozkan C, Akturk M, Gulbahar O, Yalcin M, Cakir N, Toruner FB (2016) Vitamin D-binding protein and free vitamin D concentrations in acromegaly. Endocrine 52:374–379CrossRefPubMed

29.

Mazziotti G, Cimino V, De Menis E, Bonadonna S, Bugari G, De Marinis L, Veldhuis JD, Giustina A (2006) Active acromegaly enhances spontaneous parathyroid hormone pulsatility. Metabolism 55:736–740CrossRefPubMed

30.

Schousboe JT, Shepherd JA, Bilezikian JP, Baim S (2013) Executive summary of the 2013 international society for clinical densitometry position development conference on bone densitometry. J Clin Densitom 16:455–466CrossRefPubMed

31.

Ueland T, Fougner SL, Godang K, Schreiner T, Bollerslev J (2006) Serum GH and IGF-I are significant determinants of bone turnover but not bone mineral density in active acromegaly: a prospective study of more than 70 consecutive patients. Eur J Endocrinol 155:709–715CrossRefPubMed

32.

Diamond T, Nery L, Posen S (1989) Spinal and peripheral bone mineral densities in acromegaly: the effects of excess growth hormone and hypogonadism. Ann Intern Med 111:567–573CrossRefPubMed

33.

Lesse GP, Fraser WD, Farquharson R, Hipkin L, Vora JP (1998) Gonadal status is an important determinant of bone density in acromegaly. Clin Endocrinol 48:59–65CrossRef

34.

Griffith JF, Genant HK (2012) New advances in imaging osteoporosis and its complications. Endocrine 42:39–51CrossRefPubMed

35.

Lim SV, Marenzana M, Hopkinson M, List EO, Kopchick JJ, Pereira M, Javaheri B, Roux JP, Chavassieux P, Korbonits M, Chenu C (2015) Excessive growth hormone expression in male GH transgenic mice adversely alters bone architecture and mechanical strength. Endocrinology 156:1362–1371CrossRefPubMedPubMedCentral

36.

Ueland T, Ebbesen EN, Thomsen JS, Mosekilde L, Brixen K, Flyvbjerg A, Bollerslev J (2002) Decreased trabecular bone biomechanical competence, apparent density, IGF-II and IGFBP-5 content in acromegaly. Eur J Clin Invest 32:122–128CrossRefPubMed

37.

Mazziotti G, Canalis E, Giustina A (2010) Drug-induced osteoporosis: mechanisms and clinical implications. Am J Med 123:877–884CrossRefPubMed

38.

Mazziotti G, Porcelli T, Mormando M, De Menis E, Bianchi A, Mejia C, Mancini T, De Marinis L, Giustina A (2011) Vertebral fractures in males with prolactinoma. Endocrine 39:288–293CrossRefPubMed

39.

Angeli A, Guglielmi G, Dovio A, Capelli G, de Feo D, Giannini S, Giorgino R, Moro L, Giustina A (2006) High prevalence of asymptomatic vertebral fractures in post-menopausal women receiving chronic glucocorticoid therapy: a cross-sectional outpatient study. Bone 39:253–259CrossRefPubMed

40.

Mazziotti G, Delgado A, Maffezzoni F, Formenti A, Giustina A (2016) Skeletal Fragility in Endogenous Hypercortisolism. Front Horm Res 46:66–73CrossRefPubMed

41.

Ulivieri FM, Silva BC, Sardanelli F, Hans D, Bilezikian JP, Caudarella R (2014) Utility of the trabecular bone score (TBS) in secondary osteoporosis. Endocrine 47:435–448CrossRefPubMed

42.

Hong AR, Kim JH, Kim SW, Kim SY, Shin CS (2016) Trabecular bone score as a skeletal fragility index in acromegaly patients. Osteoporos Int 27:1123–1129CrossRefPubMed

43.

Godang K, Olarescu NC, Bollerslev J, Heck A (2016) Treatment of acromegaly increases BMD but reduces trabecular bone score: a longitudinal study. Eur J Endocrinol 175:155–164CrossRefPubMed

44.

Vestergaard P, Jørgensen JO, Hagen C, Hoeck HC, Laurberg P, Rejnmark L, Brixen K, Weeke J, Andersen M, Conceicao FL, Nielsen TL, Mosekilde L (2002) Fracture risk is increased in patients with GH deficiency or untreated prolactinomas—a case-control study. Clin Endocrinol (Oxf) 56:159–167CrossRef

45.

Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ III (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227CrossRefPubMed

46.

Genant HK, Jergas M, Palermo L, Nevitt M, Valentin RS, Black D, Cummings SR (1996) Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis the Study of Osteoporotic Fractures Research Group. J Bone Miner Res 11:984–996CrossRefPubMed

47.

Bonadonna S, Mazziotti G, Nuzzo M, Bianchi A, Fusco A, De Marinis L, Giustina A (2005) Increased prevalence of radiological spinal deformities in active acromegaly: a cross-sectional study in postmenopausal women. J Bone Miner Res 20:1837–1844CrossRefPubMed

48.

Mazziotti G, Bianchi A, Bonadonna S, Cimino V, Patelli I, Fusco A, Pontecorvi A, De Marinis L, Giustina A (2008) Prevalence of vertebral fracture in men with acromegaly. J Clin Endocrinol Metab 93:4649–4655CrossRefPubMed

49.

Battista C, Chiodini I, Muscarella S, Guglielmi G, Mascia ML, Carnevale V, Scillitani A (2009) Spinal volumetric trabecular bone mass in acromegalic patients: a longitudinal study. Clin Endocrinol 70:378–382CrossRef

50.

Wassenaar MJ, Biermasz NR, Hamdy NA, Zillikens MC, van Meurs JB, Rivadeneira F, Hofman A, Uitterlinden AG, Stokkel MP, Roelfsema F, Kloppenburg M, Kroon HM, Romijn JA, Pereira AM (2011) High prevalence of vertebral fractures despite normal bone mineral density in patients with long-term controlled acromegaly. Eur J Endocrinol 164:475–483CrossRefPubMed

51.

Padova G, Borzì G, Incorvaia L, Siciliano G, Migliorino V, Vetri M, Tita P (2011) Prevalence of osteoporosis and vertebral fractures in acromegalic patients. Clin Cases Miner Bone Metab 8:37–43PubMedPubMedCentral

52.

Brzana J, Yedinak CG, Hameed N, Fleseriu M (2014) FRAX score in acromegaly: does it tell the whole story? Clin Endocrinol 80:614–616CrossRef

53.

Madeira M, Neto LV, Torres CH, de Mendonça LM, Gadelha MR, de Farias ML (2013) Vertebral fracture assessment in acromegaly. J Clin Densitom 16:238–243CrossRefPubMed

54.

Mazziotti G, Bianchi A, Porcelli T, Mormando M, Maffezzoni F, Cristiano A, Giampietro A, De Marinis L, Giustina A (2013) Vertebral fractures in patients with acromegaly: a 3-year prospective study. J Clin Endocrinol Metab 98:3402–3410CrossRefPubMed

55.

Claessen KM, Kroon HM, Pereira AM, Appelman-Dijkstra NM, Verstegen MJ, Kloppenburg M, Hamdy NA, Biermasz NR (2013) Progression of vertebral fractures despite long-term biochemical control of acromegaly: a prospective follow-up study. J Clin Endocrinol Metab 98:4808–4815CrossRefPubMed

56.

Mazziotti G, Gola M, Bianchi A, Porcelli T, Giampietro A, Cimino V, Doga M, Gazzaruso C, De Marinis L, Giustina A (2011) Influence of diabetes mellitus on vertebral fractures in men with acromegaly. Endocrine 40:102–108CrossRefPubMed

57.

Mazziotti G, Porcelli T, Bianchi A, Cimino V, Patelli I, Mejia C, Fusco A, Giampietro A, De Marinis L, Giustina A (2010) Glucocorticoid replacement therapy and vertebral fractures in hypopituitary adult males with GH deficiency. Eur J Endocrinol 163:15–20CrossRefPubMed

58.

Mazziotti G, Mormando M, Cristiano A, Bianchi A, Porcelli T, Giampietro A, Maffezzoni F, Serra V, De Marinis L, Giustina A (2014) Association between l-thyroxine treatment, GH deficiency, and radiological vertebral fractures in patients with adult-onset hypopituitarism. Eur J Endocrinol 170:893–899CrossRefPubMed

59.

Johansson H, Odén A, McCloskey EV, Kanis JA (2014) Mild morphometric vertebral fractures predict vertebral fractures but not non-vertebral fractures. Osteoporos Int 25:235–241CrossRefPubMed

60.

Giustina A, Casanueva FF, Cavagnini F, Chanson P, Clemmons D, Frohman LA, Gaillard R, Ho K, Jaquet P, Kleinberg DL, Lamberts SW, Lombardi G, Sheppard M, Strasburger CJ, Vance ML, Wass JA, Melmed S (2003) Diagnosis and treatment of acromegaly complications. J Endocrinol Invest 26:1242–1247CrossRefPubMed

61.

Melmed S, Casanueva FF, Klibanski A, Bronstein MD, Chanson P, Lamberts SW, Strasburger CJ, Wass JA, Giustina A (2013) A consensus on the diagnosis and treatment of acromegaly complications. Pituitary 16:294–302CrossRefPubMed

62.

Ben-Shlomo A, Sheppard MC, Stephens JM, Pulgar S, Melmed S (2011) Clinical, quality of life, and economic value of acromegaly disease control. Pituitary 14:284–294CrossRefPubMedPubMedCentral

63.

Crespo I, Webb SM (2014) Perception of health and cognitive dysfunction in acromegaly patients. Endocrine 46:365–367CrossRefPubMed

64.

Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, Kanis J (2000) Health related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392CrossRefPubMed

65.

Giustina A, Bronstein MD, Casanueva FF, Chanson P, Ghigo E, Ho KK, Klibanski A, Lamberts S, Trainer P, Melmed S (2011) Current management practices for acromegaly: an international survey. Pituitary 14:125–133CrossRefPubMed

66.

Giustina A, Mazziotti G, Torri V, Spinello M, Floriani I, Melmed S (2012) Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS One 7:e36411CrossRefPubMedPubMedCentral

67.

Maison P, Tropeano AI, Macquin-Mavier I, Giustina A, Chanson P (2007) Impact of somatostatin analogs on the heart in acromegaly: a metaanalysis. J Clin Endocrinol Metab 92:1743–1747CrossRefPubMed

68.

Neggers SJ, van Aken MO, de Herder WW, Feelders RA, Janssen JA, Badia X, Webb SM, van der Lely AJ (2008) Quality of life in acromegalic patients during long-term somatostatin analog treatment with and without pegvisomant. J Clin Endocrinol Metab 93:3853–3859CrossRefPubMed

69.

Mazziotti G, Marzullo P, Doga M, Aimaretti G, Giustina A (2015) Growth hormone deficiency in treated acromegaly. Trends Endocrinol Metab 26:11–21CrossRefPubMed

70.

Frara S, Maffezzoni F, Mazziotti G, Giustina A (2016) The modern criteria for medical management of acromegaly. Prog Mol Biol Transl Sci 138:63–83CrossRefPubMed

71.

Giustina A, Bevan JS, Bronstein MD, Casanueva FF, Chanson P, Petersenn S, Thanh XM, Sert C, Houchard A, Guillemin I, Melmed S, SAGIT Investigator Group (2016) SAGIT^®: clinician-reported outcome instrument for managing acromegaly in clinical practice development and results from a pilot study. Pituitary 19:39–49CrossRefPubMed

Titel: Acromegalic osteopathy
verfasst von: G. Mazziotti
F. Maffezzoni
S. Frara
A. Giustina
Publikationsdatum: 05.10.2016
Verlag: Springer US
Erschienen in: Pituitary / Ausgabe 1/2017
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI: https://doi.org/10.1007/s11102-016-0758-6

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