Bone MicroArchitecture in Acromegaly

Growth hormone (GH) and Insulin-Like Growth Factor-1 (IGF-1) are important regulators of bone modeling and remodeling, fundamental to maintenance of normal skeletal integrity. In acromegaly, a disease characterized by longstanding exposure to excess GH and IGF-1, these hormones induce marked skeletal changes. Most dual energy X-ray absorptiometry (DXA) studies report that bone mineral density (BMD) is normal in acromegaly. Despite this, however, there is mounting evidence that bone health is adversely affected in patients with both active and successfully treated acromegaly.

Inclusion criteria

• Individuals with acromegaly
• On pegvisomant therapy with a normal IGF-1 level for at least 1 year

Exclusion criteria

• Malignancy (except cured basal, squamous cell skin carcinoma or other cured cancers free from recurrence > 3 years)
• Pregnancy or lactation within last 12 months
• Untreated primary hyperparathyroidism, hyper- or hypothyroidism
• Cushing's syndrome
• Prolactin-secreting pituitary adenoma
• GH deficiency
• On current drug therapy for osteoporosis
• Diabetes mellitus
• Renal insufficiency
• Liver disease
• Current or past use of glucocorticoids (more than physiologic dose), anticonvulsants, anticoagulants, methotrexate, aromatase inhibitors