Vertebral fractures occur despite control of acromegaly and are predicted by cortical volumetric bone mineral density.

2021 
INTRODUCTION Recent studies suggest that cortical bone could also play a role in vertebral fracture (VF) development in acromegaly. OBJECTIVE Evaluate the occurrence of the VF and their relationship to DXA-derived bone parameters. PATIENTS AND METHODS A single-center two year prospective study of acromegaly patients was conducted. Each subject had L1-4 spine, femoral neck and total hip (TH) aBMD measured using DXA, and TBS measurement performed. 3D Shaper™ was used to assess proximal femur trabecular and cortical volumetric (v)BMD, cortical surface (s)BMD and cortical thickness (Cth). VF assessment was performed using the lateral spine imaging IVA™ mode with a Hologic Horizon® densitometer using semi-quantitative approach. Study outcomes were assessed at two time points -baseline and month 24. RESULTS Seventy acromegaly patients (34 M/36F; average 55.1 years) were studied, including 26 with active disease. In 13 patients, nine of whom with controlled disease, VF was observed. A decrease of TBS, sBMD, neck trabecular vBMD, TH and neck cortical vBMD in VF in comparison to non-VF subjects was observed (p<0.05). Multivariate analysis of fracture prediction showed TH cortical vBMD as best fracture prediction parameter with AUC 0.774. TBS was negatively associated with fasting plasma glucose (FPG) and HBA1c at each time point during the follow-up. CONCLUSIONS From the total number of 13 VF subjects, 9 of whom occurred in controlled disease group. The most sensitive and specific predictor of incident VF was TH cortical vBMD, suggesting that cortical bone is involved in fracture development.
    • Correction
    • Source
    • Cite
    • Save
    • Machine Reading By IdeaReader
    25
    References
    0
    Citations
    NaN
    KQI
    []