Prevalence of Vertebral Fractures in Men with Acromegaly
Prevalence of Vertebral Fractures in Men with Acromegaly
复制标题
DOI：
10.1210/jc.2008-0791
复制
发表时间：
2008-12-01
影响因子：
5.8
通讯作者：
Giustina, Andrea
中科院分区：
文献类型：
--
作者：
Mazziotti, Gherardo;Bianchi, Antonio;Giustina, Andrea
背景：关于肢端肥大症骨质疏松性骨折的数据有限。在患有活动性肢端肥大症的绝经后妇女中，已经观察到放射性椎骨骨折的患病率有所增加。目前尚不清楚这一观察结果是否可能反映出肢端肥大症患者骨折风险更普遍增加。设计：这是一项横断面研究。背景：该研究在转诊中心进行。患者和对照受试者：受试者包括 40 名肢端肥大症男性（25 名疾病得到控制的患者和 15 名活动性疾病患者）和 31 名对照男性，年龄和性腺状况与患者相当。干预措施：评估椎骨骨折（定量）进行形态测量分析）和腰椎和全髋骨密度（BMD）（双能 X 射线骨密度测定）。主要结果测量：评估椎骨骨折。结果：虽然肢端肥大症患者和对照受试者之间的 BMD 没有显着差异，但与对照受试者相比，肢端肥大症患者的椎骨骨折发生率较高（57.5% vs. 22.6%；chi(2)： 8.7；P = 0.003）。骨折和非骨折肢端肥大症患者的年龄和 BMD Z 评分没有显着差异。然而，与无骨折的患者相比，肢端肥大症骨折患者的血清 IGF-I 值显着更高，活动性疾病持续时间显着更长。此外，与没有骨折的患者相比，骨折患者未经治疗的性腺功能减退症的时间明显更长。在多变量逻辑回归分析中，活动性肢端肥大症的持续时间是与骨折发生显着相关的唯一危险因素（比值比1.1，置信区间1.04-1.6）。结论：这项研究首次报告，在通常被认为骨质疏松风险较低的未经选择的肢端肥大症男性人群中，骨质疏松性椎体骨折的患病率很高，这表明复杂性骨质疏松症是骨质疏松症的重要合并症。肢端肥大症。 (临床内分泌代谢杂志 93: 4649-4655, 2008)
Context: Data on osteoporotic fractures in acromegaly are limited. An increased prevalence of radiological vertebral fractures was already observed in postmenopausal women with active acromegaly. It is unknown whether this observation may reflect a more general increased risk of fractures in acromegaly.Design: This was a cross-sectional study.Setting: The study was conducted at referral centers.Patients and Control Subjects: Subjects included 40 males with acromegaly (25 patients with controlled disease and 15 patients with active disease) and 31 control males, with age and gonadal status comparable with the patients.Interventions: Evaluation of vertebral fractures (quantitative morphometric analysis) and bone mineral density (BMD) at lumbar spine and total hip (dual energy X-ray absorptiometry) was done.Main Outcome Measure: Vertebral fractures were assessed.Results: Although BMD was not significantly different between acromegalic patients and control subjects, the prevalence of vertebral fractures was higher in acromegalic patients as compared with the control subjects (57.5 vs. 22.6%; chi(2): 8.7; P = 0.003). Fractured and nonfractured acromegalic patients showed no significant difference in age and BMD Z-score. However, acromegalic patients with fractures had serum IGF-I values significantly higher and duration of active disease significantly longer with respect to patients without fractures. Moreover, patients with fractures showed significantly longer untreated hypogonadism as compared with patients without fractures. In a multivariate logistic regression analysis, the duration of active acromegaly was the only risk factor significantly correlated with the occurrence of fractures (odds ratio 1.1, confidence interval 1.04-1.6).Conclusions: This study reports for the first time a high prevalence of osteoporotic vertebral fractures in an unselected acromegalic male population generally considered at low risk of osteoporosis, suggesting that complicated osteoporosis is an important comorbidity of acromegaly. (J Clin Endocrinol Metab 93: 4649-4655, 2008)