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The effects of high serum growth hormone and IGF-1 levels on bone mineral density in acromegaly

Auswirkungen hoher Wachstumshormon- und IGF-1-Serumspiegel auf die Knochenmineraldichte bei Akromegalie

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Abstract

Objective

Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) play a major role in bone homeostasis. In this study, we aimed to assess bone mineral density (BMD) in active acromegaly.

Materials and methods

A total of 29 patients with active acromegaly (age 46.10 ± 13.27 years; body mass index [BMI]: 29.51 ± 4.91 kg/m2) and 42 healthy individuals matched for age and BMI (age: 40.35 ± 11.74 years; BMI: 28.18 ± 7.35 kg/m2) were included in the study. BMD was measured by DXA.

Results

The mean levels of GH and IGF-1 were found to be 12.61 ± 11.34 ng/ml and 676.47 ± 316.19 ng/ml in acromegaly, respectively, while the mean levels of GH and IGF-1 were found to be 0.59 ± 0.81 ng/ml (p = 0.0001) and 178.17 ± 57.11 ng/ml (p = 0.0001) in the control group, respectively. Only total hip t‑score was determined to be significantly lower in acromegaly compared to the control group (p = 0.037). No significant differences were found between the other parameters in DXA and only a positive correlation was found between IGF-1 levels and L1–L4 BMD (r = 0.259, p = 0.029).

Conclusions

Although GH and IGF-1 levels were increased in acromegalic patients, no significant difference was found in terms of vertebral BMD. Only hip t‑scores were found to be lower in acromegalic patients, but this low hip t‑score did not reach the osteopenic level. The positive correlation between IGF-1 and lumbar vertebral BMD suggested a more prominent effect of IGF-1 on BMD compared to GH.

Zusammenfassung

Ziel

Wachtumshormon („growth hormone“, GH) und der insulinähnliche Wachstumsfaktor 1 („insulin-like growth factor 1“, IGF-1) spielen eine wichtige Rolle bei der Knochenhomöostase. Ziel dieser Studie war es, die Knochenmineraldichte („bone mineral density“, BMD) bei aktiver Akromegalie zu beurteilen.

Material und Methoden

Neunundzwanzig Patienten mit aktiver Akromegalie (Alter: 46,10 ± 13,27 Jahre; Body-Mass-Index [BMI]: 29,51 ± 4,91 kg/m2) und 42 gesunde Personen mit entsprechendem Alter und BMI (Alter: 40,35 ± 11,74 Jahre; BMI: 28,18 ± 7,35 kg/m2) wurden in die Studie eingeschlossen. Die BMD wurde mittels DXA gemessen.

Ergebnisse

Die mittleren GH- und IGF-1-Serumspiegel bei Akromegalie betrugen 12,61 ± 11,34 ng/ml bzw. 676,47 ± 316,19 ng/ml, während die mittleren GH- und IGF-1-Serumspiegel in der Kontrollgruppe bei 0,59 ± 0,81 ng/ml (p = 0,0001) bzw. 178,17 ± 57,11 ng/ml (p = 0,0001) lagen. Der T‑Score der Gesamthüfte war signifikant niedriger bei Akromegalie im Vergleich zur Kontrollgruppe (p = 0,037). Es wurden keine signifikanten Unterschiede zwischen den anderen DXA-Parametern gefunden, und zwischen den IGF-1-Serumspiegeln und der BMD in L1–L4 wurde lediglich eine positive Korrelation festgestellt (r = 0,259, p = 0,029).

Schlussfolgerungen

Obwohl bei Patienten mit Akromegalie erhöhte GH- und IGF-1-Serumspiegel festgestellt wurden, gab es keine Hinweise auf signifikante Unterschiede bezüglich der BMD der Wirbelsäule. Der T‑Score der Hüfte war bei Patienten mit Akromegalie niedriger. Diese niedrigen T‑Score-Werte der Hüfte erreichten jedoch kein osteopenisches Ausmaß. Die positive Korrelation zwischen IGF-1 und der BMD im Lendenwirbelsäulenbereich zeigte, dass IGF-1 im Vergleich zu GH eine größere Auswirkung auf die BMD hat.

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Authors and Affiliations

  1. Department of Endocrinology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey

    Ş. A. Durmaz, A. Carlıoğlu & A. Tay

  2. Department of Physical Medicine and Rehabilitation, Erzurum Regional Training and Research Hospital, Erzurum, Turkey

    Z. Demircan

  3. Department of Endocrinology, Dicle University, 21280, Diyarbakır, Turkey

    Ş. A. Durmaz, A. Tuzcu & C. Beyaz

  4. Department of Nuclear Medicine, Gazi Yaşargil Training and Research Hospital, 21280, Diyarbakır, Turkey

    S. Tuzcu

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Correspondence to Ş. A. Durmaz.

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S. Tuzcu, Ş.A. Durmaz, A. Carlıoglu, Z. Demircan, A. Tuzcu, C. Beyaz and A. Tay confirm that they have no conflict of interest.

Authors confirm that all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Tuzcu, S., Durmaz, Ş.A., Carlıoğlu, A. et al. The effects of high serum growth hormone and IGF-1 levels on bone mineral density in acromegaly. Z Rheumatol 76, 716–722 (2017). https://doi.org/10.1007/s00393-016-0171-6

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