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Assessment of osteoprotegerin and RANKL levels and several cardiovascular risk scoring systems in acromegaly



The OPG/RANKL (osteoprotegerin/receptor activator of nuclear factor kappa-B) system, which plays a crucial role in bone metabolism, is also associated with vascular calcification. Acromegaly is characterized by excessive secretion of growth hormone and insulin-like growth factor, and studies have demonstrated an elevated risk of cardiovascular disease in individuals with acromegaly. In this study, our objective was to investigate the relationship between OPG/RANKL and various cardiovascular risk scoring systems.


We recruited 44 consecutive acromegaly patients and 41 healthy controls with a similar age and gender distribution for this study.


While RANKL levels were significantly higher in the acromegaly group compared to the controls, OPG levels were not found to be significantly different between the two groups. Furthermore, within the acromegaly group, RANKL levels were significantly higher in patients with active acromegaly compared to those with controlled acromegaly.

Osteoprotegerin levels showed a positive correlation with the Framingham risk score (FRS) in the acromegaly group. Linear regression analysis revealed an association of OPG with FRS (adjusted R2 value of 21.7%).


OPG and RANKL may serve as potential markers for assessment of cardiovascular calcification and prediction of the cardiovascular risk status in acromegalic patients.

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Authors and Affiliations



G.U.K and B.S.Y. wrote the manuscript.

G.U.K., I.Y.S., and B.S.Y researched the data and literature.

M.A and G.B performed the biochemical studies.

S.O. performed the statistical evaluation.

G.U.K, B.S.Y, and S.O. reviewed/edited the manuscript.

Corresponding author

Correspondence to Gokcen Unal Kocabas.

Ethics declarations


This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committe of Izmir Bozyaka Training and Research Hospital. The patients gave oral and written informed consent before recruitment (ethics approval number 7, date 24 December 2013).

Conflict of interest

The authors declare no competing interests.


Gokcen Unal Kocabas is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Kocabas, G.U., Yurekli, B.S., Simsir, I.Y. et al. Assessment of osteoprotegerin and RANKL levels and several cardiovascular risk scoring systems in acromegaly. Hormones (2023).

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