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acromegaly bone

S Tuzcu, Ş A Durmaz, A Carlıoğlu, Z Demircan, A Tuzcu, C Beyaz, A Tay
OBJECTIVE: Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) play a major role in bone homeostasis. In this study, we aimed to assess bone mineral density (BMD) in active acromegaly. MATERIALS AND METHODS: A total of 29 patients with active acromegaly (age 46.10 ± 13.27 years; body mass index [BMI]: 29.51 ± 4.91 kg/m(2)) and 42 healthy individuals matched for age and BMI (age: 40.35 ± 11.74 years; BMI: 28.18 ± 7.35 kg/m(2)) were included in the study...
October 20, 2016: Zeitschrift Für Rheumatologie
Connie Y Chang, Daniel I Rosenthal, Deborah M Mitchell, Atsuhiko Handa, Susan V Kattapuram, Ambrose J Huang
Metabolic bone diseases are a diverse group of diseases that result in abnormalities of (a) bone mass, (b) structure mineral homeostasis, (c) bone turnover, or (d) growth. Osteoporosis, the most common metabolic bone disease, results in generalized loss of bone mass and deterioration in the bone microarchitecture. Impaired chondrocyte development and failure to mineralize growth plate cartilage in rickets lead to widened growth plates and frayed metaphyses at sites of greatest growth. Osteomalacia is the result of impaired mineralization of newly formed osteoid, which leads to characteristic Looser zones...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
G Mazziotti, F Maffezzoni, S Frara, A Giustina
Acromegalic osteopathy is an emerging complication of acromegaly characterized by increase in bone turnover, deterioration in bone microarchitecture and high risk of vertebral fractures. Vertebral fractures, as diagnosed by a radiological and morphometric approach, occur in about one-third of acromegaly patients in close relationship with duration of active disease. However, the prediction of vertebral fractures in this clinical setting is still a matter of uncertainty, since the pathogenesis of acromegalic osteopathy is multifactorial and fractures may occur even in presence of normal bone mineral density...
October 5, 2016: Pituitary
Filippo Maffezzoni, Michele Maddalo, Stefano Frara, Monica Mezzone, Ivan Zorza, Fabio Baruffaldi, Francesco Doglietto, Gherardo Mazziotti, Roberto Maroldi, Andrea Giustina
Vertebral fractures are an emerging complication of acromegaly but their prediction is still difficult occurring even in patients with normal bone mineral density. In this study we evaluated the ability of high-resolution cone-beam computed tomography to provide information on skeletal abnormalities associated with vertebral fractures in acromegaly. 40 patients (24 females, 16 males; median age 57 years, range 25-72) and 21 healthy volunteers (10 females, 11 males; median age 60 years, range: 25-68) were evaluated for trabecular (bone volume/trabecular volume ratio, mean trabecular separation, and mean trabecular thickness) and cortical (thickness and porosity) parameters at distal radius using a high-resolution cone-beam computed tomography system...
September 6, 2016: Endocrine
Audrey E Arzamendi, Kiarash Shahlaie, Richard E Latchaw, Mirna Lechpammer, Hasmik Arzumanyan
OBJECTIVE: To describe the work-up and treatment of rare ectopic acromegaly caused by a biopsy-proven somatotroph pituitary adenoma located within the bony intersphenoid septum of a patient with empty sella syndrome (ESS). METHODS: We report the presentation, clinical course, diagnostic work-up, and lesion localization and treatment challenges encountered in a 55-year-old patient, with a brief review of relevant literature. RESULTS: A 55-year-old African-American man presented with acromegaly and ESS...
July 2016: Journal of Neurological Surgery Reports
Christina Dimopoulou, Sarah M Leistner, Marcus Ising, Harald J Schneider, Jochen Schopohl, Sandra Rutz, Robert Kosilek, Richard Frohner, Gunter K Stalla, Caroline Sievers
OBJECTIVE: Diagnosis of acromegaly is delayed up to 10 years after disease onset despite obvious external/objective changes such as bone and soft-tissue deformities. We hypothesized that a lack of subjective perception of the disease state, possibly mediated by psychiatric or cognitive alterations, might contribute to the delayed initiation of a diagnostic work-up. DESIGN: Cross-sectional study. METHODS: We investigated perceived body image by standardized questionnaires (FKB-20: Fragebogen zum Körperbild; FBeK: Fragebogen zur Beurteilung des eigenen Körpers) in 81 acromegalic patients and contrasted them to a) a clinical control group of 60 patients with non-functioning pituitary adenomas (NFPA) who lack severe facial and physical alterations and b) healthy controls...
July 25, 2016: Neuroendocrinology
Kristin Godang, Nicoleta Cristina Olarescu, Jens Bollerslev, Ansgar Heck
CONTEXT: Bone turnover is increased in acromegaly. Despite normalization of bone turnover after treatment, the risk for vertebral fractures remains increased. Gonadal status, but not BMD, is correlated with vertebral fractures. Trabecular bone score (TBS) is related to bone microarchitecture. OBJECTIVE: The aim of this study is to assess the longitudinal change in TBS and BMD following treatment for acromegaly. DESIGN, SETTING, PATIENTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: This longitudinal study included 48 patients with acromegaly between 2005 and 2015...
August 2016: European Journal of Endocrinology
T Rubinek, D Modan-Moses
The growth hormone (GH)/insulin-like growth factor (IGF)-1 axis is pivotal for many metabolic functions, including proper development and growth of bones, skeletal muscles, and adipose tissue. Defects in the axis' activity during childhood result in growth abnormalities, while increased secretion of GH from the pituitary results in acromegaly. In order to keep narrow physiologic concentration, GH and IGF-1 secretion and activity are tightly regulated by hypothalamic, pituitary, endocrine, paracrine, and autocrine factors...
2016: Vitamins and Hormones
Nicholas A Tritos, Anne Klibanski
PURPOSE: Describe the effects of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) on the skeleton. FINDINGS: The GH and IGF-1 axis has pleiotropic effects on the skeleton throughout the lifespan by influencing bone formation and resorption. GH deficiency leads to decreased bone turnover, delayed statural growth in children, low bone mass, and increased fracture risk in adults. GH replacement improves adult stature in GH deficient children, increases bone mineral density (BMD) in adults, and helps to optimize peak bone acquisition in patients, during the transition from adolescence to adulthood, who have persistent GH deficiency...
2016: Progress in Molecular Biology and Translational Science
Stefano Frara, Filippo Maffezzoni, Gherardo Mazziotti, Andrea Giustina
Acromegaly is an insidious disorder characterized by excess secretion of growth hormone (GH) and elevated circulating levels of insulin-like growth factor-I (IGF-I), generally caused by a pituitary adenoma. It is a rare disease associated with an average 10-year reduction in life expectancy due to metabolic, cardiovascular, and cerebrovascular comorbidities and reduced quality of life caused by paresthesias, fatigue, osteoarthralgia, or bone fractures. In 2000, Cortina Consensus Conference established general criteria for diagnosis and biochemical control of acromegaly, which have been revised in recent years, adapting them to emerging clinical evidences as well as the evolving assay techniques...
2016: Progress in Molecular Biology and Translational Science
Hande Mefkure Ozkaya, Nil Comunoglu, Fatma Ela Keskin, Buge Oz, Ozlem Asmaz Haliloglu, Necmettin Tanriover, Nurperi Gazioglu, Pinar Kadioglu
Aromatase, a key enzyme in local estrogen synthesis, is expressed in different pituitary tumors including growth hormone (GH)-secreting adenomas. We aimed to evaluate aromatase, estrogen receptor α (ERα), estrogen receptor β (ERβ), pituitary tumor transforming gene (PTTG), and fibroblast growth factor 2 (FGF2) expressions in GH-secreting adenomas, and investigate their correlation with clinical, pathologic, and radiologic parameters. This cross-sectional study was conducted in a tertiary center in Turkey...
June 2016: Endocrine
Elena Valassi, Iris Crespo, Jorge Malouf, Jaume Llauger, Anna Aulinas, Ana Maria Marín, Betina Biagetti, Susan M Webb
OBJECTIVE: Data on dual energy absorptiometry (DXA)-measured bone mineral density (BMD) at the level of the total hip (TH) and femoral neck (FN) in patients with acromegaly (ACRO) are conflicting. Increase in bone size associated with ACRO may limit the reliability of DXA. Our objective is to evaluate trabecular and cortical volumetric BMD (vBMD) across the proximal femur in ACRO patients. DESIGN: Cross sectional study in a clinical research center. PATIENTS: Thirty-five ACRO patients (19 males; mean age, 48±7 years; BMI, 27...
February 2016: European Journal of Endocrinology
A R Hong, J H Kim, S W Kim, S Y Kim, C S Shin
SUMMARY: Lumbar spine trabecular bone score (TBS) was significantly decreased in active acromegaly patients. TBS may be useful to assess the skeletal fragility in acromegaly in which bone mineral density (BMD) is not sufficient to represent bone strength and explain the high incidence of fragility fractures in acromegaly patients. INTRODUCTION: Although the data on BMD are controversial, patients with acromegaly have an increased risk of fragility fracture. We examined the lumbar spine TBS to explain the skeletal deterioration in acromegaly patients...
March 2016: Osteoporosis International
Daisuke Tamada, Tetsuhiro Kitamura, Mitsuyoshi Takahara, Satoru Oshino, Youichi Saitoh, Michio Otsuki, Iichiro Shimomura
Growth hormone and insulin-like growth factor-I play important roles in regulating bone metabolism and bone mineral density in adulthood. However, the effect of excess growth hormone on bone metabolism and bone mineral density is not fully understood. Here, we investigated the long-term changes in bone metabolism and bone mineral density after a rapid decline in growth hormone levels due to transsphenoidal surgery in acromegalic patients. Eighteen acromegalic patients (10 males and 8 females) who underwent transsphenoidal surgery were enrolled in this prospective study...
2015: Endocrine Journal
Mark A Sperling
Growth hormone has been known to be diabetogenic for almost a century and it's diabetogenic properties fostered consideration of excessive and abnormal GH secretion as a cause of diabetes, as well as a role in the microvascular complications, especially retinopathy. However, besides inducing insulin resistance, GH also is lipolytic and a major anabolic hormone for nitrogen retention and protein synthesis. These actions are best illustrated at the extremes of GH secretion: Gigantism/acromegaly is characterized by excessive growth, CHO intolerance, hyperplasia of bone, little body fat and prominent muscle development, whereas total deficiency of GH secretion or action is associated with adiposity, poor growth, and poor muscle development...
June 2016: Growth Hormone & IGF Research
Faryal Mirza, Ernesto Canalis
Osteoporosis is a skeletal disorder characterized by decreased mass and compromised bone strength predisposing to an increased risk of fractures. Although idiopathic osteoporosis is the most common form of osteoporosis, secondary factors may contribute to the bone loss and increased fracture risk in patients presenting with fragility fractures or osteoporosis. Several medical conditions and medications significantly increase the risk for bone loss and skeletal fragility. This review focuses on some of the common causes of osteoporosis, addressing the underlying mechanisms, diagnostic approach and treatment of low bone mass in the presence of these conditions...
September 2015: European Journal of Endocrinology
Marek Bolanowski, Jowita Halupczok, Aleksandra Jawiarczyk-Przybyłowska
Various hormonal disorders can influence bone metabolism and cause secondary osteoporosis. The consequence of this is a significant increase of fracture risk. Among pituitary disorders such effects are observed in patients with Cushing's disease, hyperprolactinemia, acromegaly, and hypopituitarism. Severe osteoporosis is the result of the coexistence of some of these disorders and hypogonadism at the same time, which is quite often.
2015: International Journal of Endocrinology
Joan Viciano, Stefano De Luca, Sandra López-Lázaro, Daniel Botella, Juan Pablo Diéguez-Ramírez
Pituitary gigantism is a rare endocrine disorder caused by hypersecretion of growth hormone during growing period. Individuals with this disorder have an enormous growth in height and associated degenerative changes. The continued hypersecretion of growth hormone during adulthood leads to acromegaly, a condition related to the disproportionate bone growth of the skull, hands and feet. The skeletal remains studied belong to a young adult male from the Jewish necropolis of "Ronda Sur" in Lucena (Córdoba, Spain, VIII-XII centuries CE)...
2015: Anthropologischer Anzeiger; Bericht über die Biologisch-anthropologische Literatur
Milap D Raikundalia, Morgan J Pines, Peter F Svider, Soly Baredes, Adam J Folbe, James K Liu, Jean Anderson Eloy
BACKGROUND: Transsphenoidal surgery (TSS) is a common procedure for a variety of pituitary lesions. This procedure can be associated with complications related to the surgery or specific pathology. In this study, we evaluate inpatient postoperative complications among patients who underwent TSS for growth hormone adenomas using a nationally representative database, and compare patient characteristics and complications to patients who underwent TSS for other benign pituitary neoplasms...
May 2015: International Forum of Allergy & Rhinology
Gherardo Mazziotti, Silvia Chiavistelli, Andrea Giustina
Pituitary hormones have direct and indirect effects on bone remodeling, and skeletal fragility is a frequent complication of pituitary diseases. Fragility fractures may occur in many patients with prolactinomas, acromegaly, Cushing disease, and hypopituitarism. As in other forms of secondary osteoporosis, pituitary diseases generally affect bone quality more than bone quantity, and fractures may occur even in the presence of normal or low-normal bone mineral density, making difficult the prediction of fractures in these settings...
March 2015: Endocrinology and Metabolism Clinics of North America
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