title: Rapid decline in bone turnover markers but not bone mineral density in acromegalic patients after transsphenoidal surgery.
abstract: Growth hormone (GH) and insulin-like growth factor-I (IGF-I) play important roles in maintaining bone metabolism and bone mineral density (BMD) in adulthood, in addition to stimulating longitudinal bone growth in childhood. However, information on the effect of GH excess on bone metabolism and BMD is incomplete and requires further analysis. The aim of this study is to clarify the effect of rapid decline in GH levels after transsphenoidal surgery (TSS) on bone metabolism in acromegalic patients. In this prospective study, 22 patients (11 males and 11 females) with active acromegaly underwent TSS. Bone formation marker (serum bone alkaline phosphatase: BAP), bone resorption marker (urinary type I collagen cross-linked N-telopeptide: urinary NTx) and BMD were measured before and at 3 and 12 months after TSS. BAP was significantly decreased at 12 months after TSS, but not at 3 months. Urinary NTx was significantly decreased at 3 and 12 months after TSS. BMD did not change after TSS. In conclusion, the rapid fall in GH level after TSS had no effect on BMD for up to 12 months after TSS despite the decrease in markers of bone formation and resorption.
authors.affiliation: Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tamada
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Kitamura
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Onodera
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tabuchi
authors.forename: Atsunori
authors.initials: A
authors.lastname: Fukuhara
authors.forename: Satoru
authors.initials: S
authors.lastname: Oshino
authors.forename: Youichi
authors.initials: Y
authors.lastname: Saitoh
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Michio
authors.initials: M
authors.lastname: Otsuki
authors.forename: Iichiro
authors.initials: I
authors.lastname: Shimomura
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000378:metabolism / Q000601:surgery* / Q000652:urine; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density; D016723:Bone Remodeling; D001862:Bone Resorption; D001842:Bone and Bones / Q000378:metabolism*; D024042:Collagen Type I; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010455:Peptides; D011446:Prospective Studies
chemical_list: D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D019382:Human Growth Hormone; D000469:Alkaline Phosphatase