Prevalence of vertebral fractures in men with acromegaly.
BACKGROUND
Data on osteoporotic fractures in acromegaly are limited. An increased prevalence of radiological vertebral fractures was already observed in postmenopausal women with active acromegaly. It is unknown whether this observation may reflect a more general increased risk of fractures in acromegaly.


METHODS
This was a cross-sectional study.


METHODS
The study was conducted at referral centers.


METHODS
Subjects included 40 males with acromegaly (25 patients with controlled disease and 15 patients with active disease) and 31 control males, with age and gonadal status comparable with the patients.


METHODS
Evaluation of vertebral fractures (quantitative morphometric analysis) and bone mineral density (BMD) at lumbar spine and total hip (dual energy X-ray absorptiometry) was done.


METHODS
Vertebral fractures were assessed.


RESULTS
Although BMD was not significantly different between acromegalic patients and control subjects, the prevalence of vertebral fractures was higher in acromegalic patients as compared with the control subjects (57.5 vs. 22.6%; chi(2): 8.7; P = 0.003). Fractured and nonfractured acromegalic patients showed no significant difference in age and BMD Z-score. However, acromegalic patients with fractures had serum IGF-I values significantly higher and duration of active disease significantly longer with respect to patients without fractures. Moreover, patients with fractures showed significantly longer untreated hypogonadism as compared with patients without fractures. In a multivariate logistic regression analysis, the duration of active acromegaly was the only risk factor significantly correlated with the occurrence of fractures (odds ratio 1.1, confidence interval 1.04-1.6).


CONCLUSIONS
This study reports for the first time a high prevalence of osteoporotic vertebral fractures in an unselected acromegalic male population generally considered at low risk of osteoporosis, suggesting that complicated osteoporosis is an important comorbidity of acromegaly.
Mazziotti
Gherardo
G
Department of Medical and Surgical Sciences, University of Brescia, c/o Endocrinology Service, Montichiari Hospital, Via Ciotti 154, 25018 Montichiari, Italy.
Bianchi
Antonio
A
Bonadonna
Stefania
S
Cimino
Vincenzo
V
Patelli
Ilaria
I
Fusco
Alessandra
A
Pontecorvi
Alfredo
A
De Marinis
Laura
L
Giustina
Andrea
A
D015502:Absorptiometry, Photon; D000172:Acromegaly / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D006615:Hip / Q000000981:diagnostic imaging; D006801:Humans; D007006:Hypogonadism / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010024:Osteoporosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D010907:Pituitary Hormones / Q000097:blood; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology*; D055815:Young Adult
D010907:Pituitary Hormones