Epicardial fat is a negative predictor of spine volumetric bone mineral density and trabecular bone score in acromegaly
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Growth hormone (GH) and insulin-like growth factor-I (IGF-I) excess in acromegaly (ACRO) are associated with abnormal bone remodeling and fat distribution . GH and IGF-I play an important role in regulating body composition and modulating the interaction linking bone and fat. While GH is lipolytic and stimulates lipid oxidation , GH and IGF-I play an anabolic effect on bone, enhancing osteoblast differentiation and bone formation . Thus, ACRO may be an interesting model to gain insight into the relationship between bone and fat, and its potential hormone determinants.
Patients with ACRO are at elevated risk of vertebral fractures , even in the presence of normal areal bone mineral density (aBMD), suggesting that exposure to GH/IGF-I excess may be associated with impaired bone microarchitecture . ACRO is also characterized by a change in fat distribution, namely reductions of both subcutaneous (SAT) and visceral abdominal adipose tissue (VAT) . Epicardial...
KeywordsAcromegaly Epicardial fat Volumetric bone mineral density Trabecular bone score Dickkopf-related protein 1 (DKK1)
Areal bone mineral density
C-terminal telopeptide of type 1 collagen
Areal bone mineral density
Dickkopf-related protein 1
Dual-energy X-ray absorptiometry
Epicardial adipose tissue
Free fatty acids
Growth hormone deficiency
Insulin-like growth factor-I
- LS vBMD
Lumbar spine volumetric bone mineral density
Multidetector computed tomography
Recombinant growth hormone
Quantitative computed tomography
Subcutaneous adipose tissue
Trabecular bone score
Total procollagen type 1 amino-terminal propeptide
Visceral adipose tissue
We gratefully acknowledge Silvia Herrera-Bachs, Mª Rosa Sust Martínez, and Rosa Homs Serradesanferm for their technical support. We are indebted to all the subjects participating in this study.
This work was supported by the Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation (FIS PI 11-00001 y FIS PI 14-0194), and FEDER funds, and Fundación Salud 2000 (Merck Serono Grant 2012). E.V. is a recipient of a “Juan de la Cierva” postdoctoral grant from the Spanish Ministry of Economy and Competitiveness (MINECO).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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