title: Acromegaly has a negative influence on trabecular bone, but not on cortical bone, as assessed by high-resolution peripheral quantitative computed tomography.
abstract: BACKGROUND
  Acromegaly is one of the causes of secondary osteoporosis, although studies of bone mineral density (BMD) have yielded conflicting results and none of them have evaluated the bone properties.
  
  
  OBJECTIVE
  Our objective was to correlate, in a cohort of 82 acromegalic patients, BMD and bone microarchitecture, using dual-energy x-ray absorptiometry and high-resolution peripheral quantitative computed tomography, with the presence of type 2 diabetes mellitus (T2DM), disease activity, and gonadal status and to compare these bone parameters between 45 eugonadal acromegalic patients and 45 healthy controls.
  
  
  RESULTS
  Acromegalic patients with T2DM had lower trabecular density and trabecular bone volume to tissue volume ratio in the distal tibia. Patients with active acromegaly exhibited a higher BMD and T-score in the lumbar spine (P = .02 for both) and a higher cortical density in the distal tibia when compared with those with controlled acromegaly (P = .001). After multiple linear regression (including age, presence of T2DM, acromegaly activity, and gonadal status), eugonadism remained the main determinant of bone parameters. The 45 acromegalic patients with eugonadism were compared with 45 age- and sex-matched controls and exhibited lower trabecular densities and impaired microstructures.
  
  
  CONCLUSIONS
  Acromegaly appears to have a deleterious effect on trabecular bone microarchitecture, and in this specific population, the gonadal status might be more important than T2DM or acromegaly activity in determining bone health. High-resolution peripheral quantitative computed tomography seems promising for evaluating acromegalic bone properties and for addressing the limitations posed by dual-energy x-ray absorptiometry.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Hospital Universitário Clementino Fraga Filho/Universidade Federaldo Rio de Janeiro, Rio de Janeiro, Brazil. miguelmadeira@cremerj.org.br
authors.forename: Miguel
authors.initials: M
authors.lastname: Madeira
authors.forename: Leonardo Vieira
authors.initials: LV
authors.lastname: Neto
authors.forename: Francisco
authors.initials: F
authors.lastname: de Paula Paranhos Neto
authors.forename: Inayá Corrêa
authors.initials: IC
authors.lastname: Barbosa Lima
authors.forename: Laura Maria
authors.initials: LM
authors.lastname: Carvalho de Mendonça
authors.forename: Mônica Roberto
authors.initials: MR
authors.lastname: Gadelha
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Fleiuss de Farias
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000378:metabolism; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013977:Tibia / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*