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Conventional X-rays in the diagnosis and follow-up of vertebral fractures in patients with acromegaly: a real-life study

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Abstract

Objectives

To explore the role of conventional X-ray imaging in detecting vertebral fractures (VFs) in patients with acromegaly, both at diagnosis of disease and at the last clinical visit. The risk factors for VFs were also evaluated.

Design and methods

A retrospective cohort study was conducted on 60 consecutive patients with acromegaly, in a tertiary referral centre. Thoracolumbar spine radiography (X-spine) was performed at the last clinical visit during the follow-up in order to detect VFs. Routine chest radiograph, performed as a part of the general evaluation at diagnosis of acromegaly, were retrospectively analysed to screen for baseline VFs.

Results

At diagnosis of acromegaly, chest X-ray revealed that 10 (17%) patients had VFs. Of the 50 patients without VFs at diagnosis of acromegaly, 33 (66%) remained unfractured at the last clinical visit (median [IQR] time, 144 [96–192] months after the diagnosis of acromegaly), whereas 17 (34%) had VFs. Overall, 22 patients (37%) had novel VFs detected on X-spine including five patients with previous VFs. Risk factor for incident VFs was the presence of hypogonadism at diagnosis of acromegaly (p = 0.016).

Conclusions

In acromegaly patients, conventional X-rays can detect vertebral fractures early at diagnosis of acromegaly. They can also reveal incident VFs, which may occur several years later even in patients without VFs at diagnosis, above all in relation to hypogonadism.

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Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Acknowledgements

We would like to thank Adrian Wallwork for editing the English.

Funding

This work was partly supported by an unrestricted grant from Ipsen S.p.A. This investigator-sponsored study was funded by Ipsen, who had no input in the study design, analysis or interpretation of results. Ipsen reviewed the manuscript before submission.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Pisa, Pisa, Italy

    C. Sardella, C. Urbani, G. Marconcini, D. Cappellani, L. Manetti, C. Marcocci & F. Bogazzi

  2. 2nd Radiology Unit, Radiology Department, Pisa University Hospital, 56124, Pisa, Italy

    A. De Liperi & C. Romei

  3. Section of Statistics, Pisa University Hospital, 56126, Pisa, Italy

    R. Morganti

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  1. C. Sardella
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Sardella, C., Urbani, C., Marconcini, G. et al. Conventional X-rays in the diagnosis and follow-up of vertebral fractures in patients with acromegaly: a real-life study. J Endocrinol Invest 47, 325–334 (2024). https://doi.org/10.1007/s40618-023-02148-7

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