Understanding the effect of acromegaly on the human skeleton

ABSTRACT

Introduction: Acromegaly, caused in most cases by Growth Hormone (GH)-secreting pituitary adenomas, is characterized by increased skeletal growth and enlargement of the soft tissue, because GH and its effector Insulin-like Growth factor-1 are important regulators of bone homeostasis and have a central role in the longitudinal bone growth and maintenance of bone mass.

Areas covered: Despite the anabolic effect of these hormones is well known, as a result of the stimulation of bone turnover and especially of bone formation, many acromegalic patients are suffering from a form of secondary osteoporosis with increased risk of fractures.

Expert commentary: In this review, we summarize the pathophysiology, diagnosis, clinical picture, disease course and management of skeletal complications of acromegaly, focusing in particular on secondary osteoporosis and fracture risk in acromegaly.

KEYWORDS:

• Acromegaly
• GH
• IGF-1
• secondary osteoporosis
• vertebral fractures
• bone mineral density
• arthropathy
• bone turnover

Financial & competing interests disclosure

L. De Marinis received a research grant from Ipsen, was a principal investigator for Novartis and took part in a protocol for Pfizer. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.