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High-resolution-cone beam tomography analysis of bone microarchitecture in patients with acromegaly and radiological vertebral fractures

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Abstract

Vertebral fractures are an emerging complication of acromegaly but their prediction is still difficult occurring even in patients with normal bone mineral density. In this study we evaluated the ability of high-resolution cone-beam computed tomography to provide information on skeletal abnormalities associated with vertebral fractures in acromegaly. 40 patients (24 females, 16 males; median age 57 years, range 25–72) and 21 healthy volunteers (10 females, 11 males; median age 60 years, range: 25–68) were evaluated for trabecular (bone volume/trabecular volume ratio, mean trabecular separation, and mean trabecular thickness) and cortical (thickness and porosity) parameters at distal radius using a high-resolution cone-beam computed tomography system. All acromegaly patients were evaluated for morphometric vertebral fractures and for mineral bone density by dual-energy X-ray absorptiometry at lumbar spine, total hip, femoral neck, and distal radius. Acromegaly patients with vertebral fractures (15 cases) had significantly (p < 0.05) lower bone volume/trabecular volume ratio, greater mean trabecular separation, and higher cortical porosity vs. nonfractured patients, without statistically significant differences in mean trabecular thickness and cortical thickness. Fractured and nonfractured acromegaly patients did not have significant differences in bone density at either skeletal site. Patients with acromegaly showed lower bone volume/trabecular volume ratio (p = 0.003) and mean trabecular thickness (p < 0.001) and greater mean trabecular separation (p = 0.02) as compared to control subjects, without significant differences in cortical thickness and porosity. This study shows for the first time that abnormalities of bone microstructure are associated with radiological vertebral fractures in acromegaly. High-resolution cone-beam computed tomography at the distal radius may be useful to evaluate and predict the effects of acromegaly on bone microstructure.

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Funding

This study was partially supported by GIOSEG, University of Brescia and MIUR.

Author Contributions

F.M., M.Ma., G.M., R.M., and A.G. designed the study, did the analyses, interpreted the findings, and wrote and revised the report. S.F., M.Me., I.Z., and F.D. contributed to data collection and data preparation. F.B. contributed to technical support. All authors contributed to critical reading and revision of the draft report.

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Authors and Affiliations

  1. Endocrinology Unit, University of Brescia, Brescia, Italy

    Filippo Maffezzoni, Stefano Frara, Monica Mezzone, Gherardo Mazziotti & Andrea Giustina

  2. Radiology Unit, University of Brescia, Brescia, Italy

    Michele Maddalo, Ivan Zorza & Roberto Maroldi

  3. Medical Technology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy

    Fabio Baruffaldi

  4. Neurosurgery Unit, University of Brescia, Brescia, Italy

    Francesco Doglietto

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  1. Filippo Maffezzoni
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  2. Michele Maddalo
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  3. Stefano Frara
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  4. Monica Mezzone
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  5. Ivan Zorza
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  8. Gherardo Mazziotti
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  9. Roberto Maroldi
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  10. Andrea Giustina
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Correspondence to Andrea Giustina.

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Conflict of interest

G.M. received consultant fees from Novartis Farma and Ipsen and received lecture fee from Ipsen A.G. is a consultant for Ipsen, Novartis, and Pfizer. F.M., M.M., S.F., M.M., I.Z., F.B., F.D., and R.M. have nothing to disclose.

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Maffezzoni, F., Maddalo, M., Frara, S. et al. High-resolution-cone beam tomography analysis of bone microarchitecture in patients with acromegaly and radiological vertebral fractures. Endocrine 54, 532–542 (2016). https://doi.org/10.1007/s12020-016-1078-3

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