Impaired Bone Microarchitecture in Premenopausal Women With Acromegaly: The Possible Role of Wnt Signaling

Author(s)

Silva, Paula P. B. ^[1] ; Pereira, Rosa M. R. ^{[2, 3]} ; Takayama, Liliam ^[3] ; Borba, Clarissa G. ^[1] ; Duarte, Felipe H. ^[1] ; Trarbach, Ericka B. ^[4] ; Martin, Regina Matsunaga ^[5] ; Bronstein, Marcello D. ^{[1, 4]} ; Tritos, Nicholas A. ^{[6, 7]} ; Jallad, Raquel S. ^{[1, 4]}

Affiliation

^[1] Univ Sao Paulo, Hosp Clin, Div Endocrinol & Metab, Neuroendocrine Unit, Med Sch, BR-05403010 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Hosp Clin, Rheumatol Div, Bone Metab Lab, Med Sch, BR-01246903 Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Rheumatol Div Hosp Clin HCFMUSP, Fac Med, BR-05403010 Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Hosp Clin HCFMUSP, Lab Endocrinol Celular & Mol LIM25, Fac Med, Disciplina Endocrinol, BR-01246903 Sao Paulo, SP - Brazil

^[5] Univ Sao Paulo HC FMUSP, Hosp Clin, Fac Med, Endocrinol Serv, Dis Unit Osteometab, BR-05403010 Sao Paulo, SP - Brazil

^[6] Harvard Med Sch, Boston, MA 02114 - USA

^[7] Massachusetts Gen Hosp, Neuroendocrine Unit, Boston, MA 02114 - USA

• Document type: Journal article
• Source: JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM; v. 106, n. 9, p. 2690-2706, SEP 2021.
• Web of Science Citations: 0

Abstract

Context: Acromegaly can impair bone integrity, increasing the risk of vertebral fractures (VFs). Objective: To evaluate the impact of isolated GH/IGF-I hypersecretion on bone turnover markers, Wnt inhibitors, bone mineral density (BMD), microarchitecture, bone strength and vertebral fractures in female patients with acromegaly (Acro), compared with healthy control group (HC). Design, setting, and patients: Cross-sectional study including 83 premenopausal women without any pituitary deficiency:18 acromegaly in remission (AcroR), 12 in group with active acromegaly (AcroA), and 53 HC. Serum procollagen type 1 N-terminal propeptide, beta-carboxy-terminal crosslinked telopeptide of type 1 collagen, osteocalcin, sclerostin, and DKK1 were measured in blood samples. dual-energy X-ray absorptiometry, high-resolution peripheral quantitative computed tomography (HR-pQCT) and vertebral fractures evaluation were also assessed simultaneously. Main outcome and results: AcroA showed significantly lower sclerostin and higher DKK1 compared with HC. On HR-pQCT of tibia and radius, Acro showed impairment of trabecular (area and trabecular number), increased cortical porosity, and increased cortical area and cortical thickness compared with HC. The only significant correlation found with HR-pQCT parameters was a positive correlation between cortical porosity and serum DKK1 (R= 0.45, P= 0.044). Mild VFs were present in approximately 30% of patients. Conclusions: Eugonadal women with acromegaly without any pituitary deficiency showed increased cortical BMD, impairment of trabecular bone microstructure, and increased VF. Sclerostin was not correlated with any HR-pQCT parameters; however, DKK1 was correlated with cortical porosity in tibia (P= 0.027). Additional studies are needed to clarify the role of Wnt inhibitors on bone microarchitecture impairment in acromegaly. (AU)

• FAPESP's process: 16/23765-0 - Acromegaly: mineral density, microarquitecture and bone strength before and after treatment with biphosphonate NEW TITLE: Bone microarchitecture and strength evaluation in adults with diagnosis of acromegaly
• Grantee: Raquel Soares Jallad
• Support Opportunities: Regular Research Grants