Effects of GH-IGF-I excess and gonadal status on bone mineral density and body composition in patients with acromegaly.

Autor: Madeira M; Division of Endocrinology, Department of Internal Medicine, Hospital Universitário Clementino Fraga Filho/Universidade Federal do Rio de Janeiro, Av. Brigadeiro Trompowski s/n 9 andar, Cidade Universitaria, CEP, 21044-020, Rio de Janeiro, RJ, Brazil. miguelmadeira@cremerj.org.br, Neto LV, de Lima GA, Moreira RO, de Mendonça LM, Gadelha MR, Farias ML
Jazyk: angličtina
Zdroj: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2010 Dec; Vol. 21 (12), pp. 2019-25. Date of Electronic Publication: 2010 Mar 20.
DOI: 10.1007/s00198-009-1165-x
Abstrakt: Summary: Studies on body composition and bone mineral density in acromegaly have conflicting results. Our data point to an increase in lean mass, a decrease in adipose tissue, and that the anabolic effect of GH on bone is partially dependent on modifications in body composition.
Introduction: The effects of growth hormone (GH) and insulin-like growth factor I (IGF-I) excess and gonadal status on bone mineral density (BMD) and body composition (BC) in acromegalic patients are uncertain.
Methods: Bone mineral density and BC were evaluated by dual-energy X-ray absorptiometry (Prodigy-GE) in 75 patients (22 men and 53 women) with acromegaly, mean age 48.9 ± 14.5 years. Acromegaly was considered "controlled" when serum IGF-I was within the specific age-adjusted reference range, and serum GH was lower than 2.5 ng/mL. Comparisons between groups were performed using unpaired t test or Mann-Whitney U test. Categorical variables were analyzed by chi-square (x (2)) test. In order to compare data of different subgroups stratified by disease activity and gonadal status, one-way analysis of variance (ANOVA) and Bonferroni post hoc analysis were performed. To evaluate the correlation between GH and IGF-I and densitometric parameters, Pearson and Spearman rank order correlation were performed, as appropriate.
Results: There were no differences in BMD when considering disease activity and gonadal status. Active disease and eugonadism were positively correlated to an increase in lean mass and a decrease in fat mass. After multiple linear regression, there were positive correlations between GH and Z-score at lumbar spine and between lean mass and BMD at proximal femur.
Conclusion: Our data support that GH-IGF-I excess and eugonadism have great influence on BC modifications and that the anabolic effects of GH-IGF-I on bone are, at least in part, dependent on these alterations in body composition.
Databáze: MEDLINE
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