title: Bone properties in patients with acromegaly: quantitative ultrasound of the heel.
abstract: Growth hormone (GH) deficiency and acromegaly serve as good models for investigating the effects of GH on bone remodeling. However, the results from various studies are rather conflicting. The aim of our study was to estimate the potential role of gender, disease activity, and duration on both calcaneus quantitative ultrasound (QUS) parameters and bone turnover markers in patients with acromegaly. Thirty-six acromegalic patients (17 men, 19 women) and 3 age- and gender-adjusted controls for every patient were included in the study. The disease was active in 22 patients, and was considered cured in 14 of them. In each subject, QUS of the heel and parameters of bone turnover (bone alkaline phosphatase, beta-crosslaps, and osteocalcin) were measured. The results demonstrated lower QUS values in acromegalic patients compared with the controls. When stratified by gender, the differences in QUS parameters were significant in men, but not in women. Male patients with active disease had significantly lower QUS values than those in remission. Such differences were not observed among women. Multiple regression model indicated strong association between disease activity and the QUS parameters. The group of patients with active disease had a higher level of serum beta-crosslaps, whereas osteocalcin concentration was significantly increased only in male patients with active disease. The results of our study suggest significantly lower QUS values and increased bone turnover in male patients with active acromegaly. The disease activity is the strongest predictor of the QUS parameters in acromegalic patients.
authors.affiliation: Divison of Endocrinology, Department of Internal Medicine, Zagreb University Hospital Center, Zagreb, Croatia.
authors.forename: Darko
authors.initials: D
authors.lastname: Kastelan
authors.forename: Tina
authors.initials: T
authors.lastname: Dusek
authors.forename: Ivana
authors.initials: I
authors.lastname: Kraljevic
authors.forename: Ozren
authors.initials: O
authors.lastname: Polasek
authors.forename: Zdravko
authors.initials: Z
authors.lastname: Perkovic
authors.forename: Iva
authors.initials: I
authors.lastname: Kardum
authors.forename: Zlatko
authors.initials: Z
authors.lastname: Giljevic
authors.forename: Jozo
authors.initials: J
authors.lastname: Jelcic
authors.forename: Izet
authors.initials: I
authors.lastname: Aganovic
authors.forename: Mirko
authors.initials: M
authors.lastname: Korsic
mesh_terms: D000172:Acromegaly / Q000000981:diagnostic imaging* / Q000378:metabolism*; D000328:Adult; D000469:Alkaline Phosphatase / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D015519:Bone Density; D016723:Bone Remodeling / Q000502:physiology*; D002111:Calcaneus / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003094:Collagen / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C110762:glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine; D015675:Osteocalcin; D003094:Collagen; D000469:Alkaline Phosphatase