Effects of GH-IGF-I excess and gonadal status on bone mineral density and body composition in patients with acromegaly

• Published in: Osteoporosis international 2010-12, Vol.21 (12), p.2019-2025
• Main Authors: Madeira, M, Neto, L. V, de Lima, G. A. B, Moreira, R. O, de Mendonça, L. M. C, Gadelha, M. R, Farias, M. L. F
• Format: Article
• Language: English
• Subjects: Acromegaly; Acromegaly - blood; Acromegaly - complications; Acromegaly - physiopathology; Adult; Aged; Aged, 80 and over; Biological and medical sciences; body composition; Body Composition - physiology; Bone density; Bone Density - physiology; Chronic illnesses; densitometry; Diseases of the osteoarticular system; Endocrinology; Endocrinopathies; Female; Femur - physiopathology; Gonadal status; Growth hormones; Human Growth Hormone - blood; Humans; Hypogonadism - blood; Hypogonadism - complications; Hypogonadism - physiopathology; Hypothalamus. Hypophysis. Epiphysis (diseases); Insulin-Like Growth Factor I - analysis; Insulin-like growth factors; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae - physiopathology; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Original Article; Orthopedics; Osteoarticular system. Muscles; Osteoporosis. Osteomalacia. Paget disease; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radius - physiopathology; Reproductive system; Rheumatology; somatotropin; Young Adult
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-009-1165-x

Summary Studies on body composition and bone mineral density in acromegaly have conflicting results. Our data point to an increase in lean mass, a decrease in adipose tissue, and that the anabolic effect of GH on bone is partially dependent on modifications in body composition. Introduction The effects of growth hormone (GH) and insulin-like growth factor I (IGF-I) excess and gonadal status on bone mineral density (BMD) and body composition (BC) in acromegalic patients are uncertain. Methods Bone mineral density and BC were evaluated by dual-energy X-ray absorptiometry (Prodigy-GE) in 75 patients (22 men and 53 women) with acromegaly, mean age 48.9 ± 14.5 years. Acromegaly was considered “controlled” when serum IGF-I was within the specific age-adjusted reference range, and serum GH was lower than 2.5 ng/mL. Comparisons between groups were performed using unpaired t test or Mann-Whitney U test. Categorical variables were analyzed by chi-square (x ²) test. In order to compare data of different subgroups stratified by disease activity and gonadal status, one-way analysis of variance (ANOVA) and Bonferroni post hoc analysis were performed. To evaluate the correlation between GH and IGF-I and densitometric parameters, Pearson and Spearman rank order correlation were performed, as appropriate. Results There were no differences in BMD when considering disease activity and gonadal status. Active disease and eugonadism were positively correlated to an increase in lean mass and a decrease in fat mass. After multiple linear regression, there were positive correlations between GH and Z-score at lumbar spine and between lean mass and BMD at proximal femur. Conclusion Our data support that GH-IGF-I excess and eugonadism have great influence on BC modifications and that the anabolic effects of GH-IGF-I on bone are, at least in part, dependent on these alterations in body composition.