Pubblicazioni

Autori:

Dalle Carbonare, L.; Micheletti, V.; Cosaro, E.; Valenti, M. T.; Mottes, M.; Francia, G.; Davì, M. V.

Titolo:

Bone histomorphometry in acromegaly patients with fragility vertebral fractures

Anno:

2018

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Formato:

A Stampa

Referee:

Sì

Nome rivista:

PITUITARY

ISSN Rivista:

1386-341X

N° Volume:

21

Numero o Fascicolo:

1

Intervallo pagine:

56-64

Parole chiave:

acromegaly; bone biopsy; bone fragility; vertebral fractures

Breve descrizione dei contenuti:

CONTEXT: The high risk of vertebral fractures (VFs) in acromegaly patients despite normal bone mineral density (BMD) is well known. The reasons for this paradoxical finding of skeleton fragility are poorly understood due to the limited data on bone histomorphometry in acromegaly. OBJECTIVE: This study aimed to analyze histomorphometric parameters including bone microarchitecture in acromegaly patients with VFs and normal BMD compared to normal subjects, and also to evaluate the differences between active and controlled acromegaly patients. PATIENTS AND METHODS: Forty-seven acromegaly patients (17 active, 30 controlled), median (range) age 57 years (30-88) were evaluated for bone turnover, morphometric VFs and BMD by dual-energy X-ray absorptiometry at lumbar spine and hip; 12 patients with VFs and normal BMD underwent iliac crest bone biopsy; 12 biopsies were taken at the autopsy in healthy sex and age-matched control subjects. RESULTS: The histomorphometric evaluation of acromegaly fractured patients was compared with that of normal controls and showed significantly reduced median (range) levels of bone volume/tissue volume (BV/TV: 15.37% (7.93-26.75) vs. 18.61% (11.75-27.31), p = 0.036), trabecular thickness (TbTh: 77.6 µm (61.7-88.3) vs. 82.7 µm (72.3-92.0) p = 0.045), with increased trabecular separation (TbSp: 536.4 µm (356.2-900.6) vs. 370.3 µm (377.1-546.3) p = 0.038) and increased cortical thickness (1268 μm (752-2521) vs. 1065 μm (851-1205) p = 0.025) and porosity (11.9% (10.2-13.3) vs. 4.8% (1.6-8.8) p = 0.0008). While active acromegaly patients showed histomophometric features of increased bone turnover, patients with controlled disease presented normal bone turnover with significantly lower osteoblastic activity, expressed as osteoblast number (p = 0.001), active osteoblasts and vigor (p = 0.014) in the presence of reduced osteocyte number (p = 0.008) compared to active disease. CONCLUSIONS: The apparent paradox of bone fragility in acromegaly patients with a normal BMD can be explained by increased cortical thickness and porosity and reduced trabecular thickness with increased trabecular separation. These structural and microarchitectural abnormalities persist in the controlled phase of acromegaly despite bone turnover normalization. The main determinant of bone disease after hormonal control is severe osteoblastic dysfunction.

Pagina Web:

https://doi.org/10.1007/s11102-017-0847-1

Id prodotto:

100103

Handle IRIS:

11562/972170

ultima modifica:

15 novembre 2022

Citazione bibliografica:

Dalle Carbonare, L.; Micheletti, V.; Cosaro, E.; Valenti, M. T.; Mottes, M.; Francia, G.; Davì, M. V., Bone histomorphometry in acromegaly patients with fragility vertebral fractures «PITUITARY» , vol. 21 , n. 1 , 2018 , pp. 56-64

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