title: Reduction of trabecular and cortical volumetric bone mineral density at the proximal femur in patients with acromegaly.
abstract: OBJECTIVE
  Data on dual energy absorptiometry (DXA)-measured bone mineral density (BMD) at the level of the total hip (TH) and femoral neck (FN) in patients with acromegaly (ACRO) are conflicting. Increase in bone size associated with ACRO may limit the reliability of DXA. Our objective is to evaluate trabecular and cortical volumetric BMD (vBMD) across the proximal femur in ACRO patients.
  
  
  METHODS
  Cross sectional study in a clinical research center.
  
  
  METHODS
  Thirty-five ACRO patients (19 males; mean age, 48±7 years; BMI, 27.5±4.4 kg/m(2); 17 with active disease) and 35 age, gender, and BMI-matched controls.
  
  
  RESULTS
  vBMD was assessed by quantitative computed tomography at the level of the TH, FN, trochanter (TR), and intertrochanteric (IT). Trabecular vBMD was lower in both total and active ACRO as compared with controls (P<0.01). Cortical vBMD was lower in ACRO patients (active and controlled) vs controls at both TH and TR sites (P<0.05). These findings were confirmed when only eugonadal patients were analyzed. Both total cross sectional area (CSA) and average cortical thickness (ACT) were greater in ACRO patients vs controls (P<0.05). An inverse association between disease duration and trabecular vBMD at TH (r=-0.42, P=0.023) and IT (r=-0.41, P=0.026) was also found.
  
  
  CONCLUSIONS
  Both cortical and trabecular vBMD are reduced at the proximal femur in ACRO patients, regardless of gender, gonadal status, and disease activity. Disease duration is negatively associated with trabecular vBMD at the TH and IT.
authors.affiliation: Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain EValassi@santpau.cat.
authors.forename: Elena
authors.initials: E
authors.lastname: Valassi
authors.affiliation: Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Iris
authors.initials: I
authors.lastname: Crespo
authors.affiliation: Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Malouf
authors.affiliation: Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Llauger
authors.affiliation: Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Aulinas
authors.affiliation: Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Marín
authors.affiliation: Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Betina
authors.initials: B
authors.lastname: Biagetti
authors.affiliation: Endocrinology/Medicine DepartmentCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), c/Sant Antoni Maria Claret 167, 08025 Barcelona, SpainMineral Metabolism UnitMedicine Department, Hospital Sant Pau, Barcelona, SpainRadiology DepartmentHospital Sant Pau, Barcelona, SpainEndocrinology DepartmentHospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Webb
mesh_terms: D015502:Absorptiometry, Photon; D000172:Acromegaly / Q000000981:diagnostic imaging*; D000328:Adult; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed