Bone MicroArchitecture in Acromegaly
Bone MicroArchitecture in Acromegaly
The investigators will conduct a cross-sectional study of bone density, bone
 microarchitecture, vertebral fractures and trabecular bone score in 25 patients with
 acromegaly treated with Pegvisomant, the growth hormone (GH) receptor antagonist for at least
 1 year and with normal insulin-like growth factor-1 (IGF-1) levels. This study aims to
 describe the bone architecture and associated biochemical indices of bone turnover and
 metabolism in patients with active acromegaly and how these are altered with treatment of the
 disease.
Growth hormone (GH) and Insulin-Like Growth Factor-1 (IGF-1) are important regulators of bone
 modeling and remodeling, fundamental to maintenance of normal skeletal integrity. In
 acromegaly, a disease characterized by longstanding exposure to excess GH and IGF-1, these
 hormones induce marked skeletal changes. Most dual energy X-ray absorptiometry (DXA) studies
 report that bone mineral density (BMD) is normal in acromegaly. Despite this, however, there
 is mounting evidence that bone health is adversely affected in patients with both active and
 successfully treated acromegaly.
Inclusion Criteria:

 -  Individuals with acromegaly

 -  On pegvisomant therapy with a normal IGF-1 level for at least 1 year

 Exclusion Criteria:

 -  Malignancy (except cured basal, squamous cell skin carcinoma or other cured cancers
 free from recurrence > 3 years)

 -  Pregnancy or lactation within last 12 months

 -  Untreated primary hyperparathyroidism, hyper- or hypothyroidism

 -  Cushing's syndrome

 -  Prolactin-secreting pituitary adenoma

 -  GH deficiency

 -  On current drug therapy for osteoporosis

 -  Diabetes mellitus

 -  Renal insufficiency

 -  Liver disease

 -  Current or past use of glucocorticoids (more than physiologic dose), anticonvulsants,
 anticoagulants, methotrexate, aromatase inhibitors