open access

Vol 72, No 3 (2021)
Original paper
Submitted: 2021-01-14
Accepted: 2021-03-01
Published online: 2021-03-22
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New insights into the metabolic-bone crosstalk in active acromegaly

Stefana Catalina Bilha1, Anca Matei1, Daniela Constantinescu2, Mariana Pavel Tanasa2, Raluca Mogos-Cioncu1, Petru Cianga2, Cristina Preda1, Dumitru D. Branisteanu1
·
Pubmed: 33749810
·
Endokrynol Pol 2021;72(3):201-210.
Affiliations
  1. Endocrinology Department, “St. Spiridon” Hospital, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
  2. Immunology Department, “St. Spiridon” Hospital, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania

open access

Vol 72, No 3 (2021)
Original Paper
Submitted: 2021-01-14
Accepted: 2021-03-01
Published online: 2021-03-22

Abstract

Introduction: Body composition (BC) and adipokines share bone active properties and display an altered profile in acromegaly. The fibroblast growth factor 23 (FGF23)/α-Klotho system, also involved in bone metabolism, is upregulated in growth hormone (GH) excess states. Hence, we aimed to investigate their impact on bone in active acromegaly, compared to controls.

Material and methods: BC, bone mineral density (BMD) (via dual X-ray absorptiometry), serum adipokines (leptin, adiponectin, resistin), parathyroid hormone (PTH), FGF23, α-Klotho, and osteocalcin were assessed in a cross-sectional study enrolling 35 patients with active acromegaly (Acro), compared to 35 sex, age, and body mass index (BMI) one-to-one matched healthy controls (CTL).

Results: The Acro group had higher bone density scores (p < 0.05), lower visceral fat depots (p = 0.011), and lower serum leptin (p < 0.001) but elevated adiponectin (p < 0.001) and resistin (p = 0.001) concentrations when compared to the CTL group. α-Klotho was not related to the GH/IGF1 axis in the Acro group. Resistin was higher in both diabetic and non-diabetic Acro compared to CTL (p < 0.05). Age and BC were the main independent BMD predictors in regression analysis in both groups, while IGF1 was a positive predictor of osteocalcin levels in the Acro (β = 0.48, p = 0.006). The correlations between adipokines, the FGF23/α-Klotho system, and bone parameters, respectively, were lost after adjusting for age and BC.

Conclusions: Age and BC were the main independent BMD predictors in the acromegalic patients with active disease, while IGF1 was independently associated with serum osteocalcin concentrations. The role of α-Klotho in evaluating acromegaly and the associated osteopathy in the long-term appears to be limited. Our study is among the first to report significant serum resistin changes in patients with active acromegaly, opening new insights in the GH-mediated insulin resistance. The GH-resistin relationship merits further investigations.

Abstract

Introduction: Body composition (BC) and adipokines share bone active properties and display an altered profile in acromegaly. The fibroblast growth factor 23 (FGF23)/α-Klotho system, also involved in bone metabolism, is upregulated in growth hormone (GH) excess states. Hence, we aimed to investigate their impact on bone in active acromegaly, compared to controls.

Material and methods: BC, bone mineral density (BMD) (via dual X-ray absorptiometry), serum adipokines (leptin, adiponectin, resistin), parathyroid hormone (PTH), FGF23, α-Klotho, and osteocalcin were assessed in a cross-sectional study enrolling 35 patients with active acromegaly (Acro), compared to 35 sex, age, and body mass index (BMI) one-to-one matched healthy controls (CTL).

Results: The Acro group had higher bone density scores (p < 0.05), lower visceral fat depots (p = 0.011), and lower serum leptin (p < 0.001) but elevated adiponectin (p < 0.001) and resistin (p = 0.001) concentrations when compared to the CTL group. α-Klotho was not related to the GH/IGF1 axis in the Acro group. Resistin was higher in both diabetic and non-diabetic Acro compared to CTL (p < 0.05). Age and BC were the main independent BMD predictors in regression analysis in both groups, while IGF1 was a positive predictor of osteocalcin levels in the Acro (β = 0.48, p = 0.006). The correlations between adipokines, the FGF23/α-Klotho system, and bone parameters, respectively, were lost after adjusting for age and BC.

Conclusions: Age and BC were the main independent BMD predictors in the acromegalic patients with active disease, while IGF1 was independently associated with serum osteocalcin concentrations. The role of α-Klotho in evaluating acromegaly and the associated osteopathy in the long-term appears to be limited. Our study is among the first to report significant serum resistin changes in patients with active acromegaly, opening new insights in the GH-mediated insulin resistance. The GH-resistin relationship merits further investigations.

Get Citation

Keywords

active acromegaly; body composition; adipokines; bone

About this article
Title

New insights into the metabolic-bone crosstalk in active acromegaly

Journal

Endokrynologia Polska

Issue

Vol 72, No 3 (2021)

Article type

Original paper

Pages

201-210

Published online

2021-03-22

Page views

1376

Article views/downloads

709

DOI

10.5603/EP.a2021.0028

Pubmed

33749810

Bibliographic record

Endokrynol Pol 2021;72(3):201-210.

Keywords

active acromegaly
body composition
adipokines
bone

Authors

Stefana Catalina Bilha
Anca Matei
Daniela Constantinescu
Mariana Pavel Tanasa
Raluca Mogos-Cioncu
Petru Cianga
Cristina Preda
Dumitru D. Branisteanu

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