Bone densitometry by radiofrequency echographic multi-spectrometry (REMS) in acromegaly patients

Rolla, Małgorzata; Halupczok-Żyła, Jowita; Jawiarczyk-Przybyłowska, Aleksandra; Bolanowski, Marek

doi:10.5603/ep.a2020.0056

Cited by 10 publications

(6 citation statements)

References 33 publications

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“…In the TCA group as well as in the TCA+ CA group, TBS was decreased in comparison to controls, while BMD was similar among these groups. These results confirmed that TBS and BMD reflect different features of bone and explain the incident of fractures in acromegaly, despite the normal BMD values ( 28 , 29 ). This can be explained by the fact that lower TBS value reflects impaired bone microstructure, which is associated with higher fracture risk.…”

Section: Discussionsupporting

confidence: 78%

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Trabecular Bone Score and Osteoprotegerin as Useful Tools in the Assessment of Bone Deterioration in Acromegaly

Jawiarczyk-Przybyłowska

Halupczok-Żyła

Syrycka

et al. 2022

Front. Endocrinol.

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PurposeThis study aimed to assess bone mineral density (BMD) and trabecular bone score (TBS) in 61 patients from the acromegaly group (AG) with regard to the activity of the disease in comparison to 42 patients—control group (CG). We also analyzed selected bone markers and their association with BMD and TBS.Materials and MethodsLumbar spine and femoral neck BMD measurements were performed. TBS values were obtained. Serum concentrations of selected bone markers, including osteoprotegerin (OPG), were measured.ResultsWe revealed a difference in TBS values between the AG and CG as well as between the TCA (treatment-controlled acromegaly) vs. CG and TCA+CA (cured acromegaly) vs. CG. We did not observe any statistically significant difference in BMD. OPG had a lower concentration in the CG compared to the AG. TBS correlated negatively with OPG in the AG (r = −0.31, p = 0.01) and in the TCA+ CA group (r = −0.3, p = 0.01).ConclusionsThe acromegalic patients have altered bone microstructure as indicated by the decreased TBS regardless of the activity of the disease and BMD. OPG could be a marker of the destruction of the bone microstructure, but further studies are needed.

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Section: Discussionsupporting

confidence: 78%

“…The disruption of trabecular bone is caused by the decreased trabecular number and increased trabecular separation. For these reasons, fractures could be present in acromegaly patients with normal or slightly decreased BMD ( 11 , 28 , 29 ). Hong et al.…”

Section: Discussionmentioning

confidence: 99%

Trabecular Bone Score and Osteoprotegerin as Useful Tools in the Assessment of Bone Deterioration in Acromegaly

Jawiarczyk-Przybyłowska

Halupczok-Żyła

Syrycka

et al. 2022

Front. Endocrinol.

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“…Trabecular bones are more prone to GH overproduction than cortical bones, which leads to impairment of its structural integrity ( 22 ). Therefore, in patients with acromegaly, fractures occur even with normal or slightly decreased BMD ( 23 – 25 ).…”

Section: Discussionmentioning

confidence: 99%

Age, body composition parameters and glycaemic control contribute to trabecular bone score deterioration in acromegaly more than disease activity

Ságová,

Mokáň,

Tonhajzerová

et al. 2023

Front. Endocrinol.

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IntroductionImpairment of bone structure in patients with acromegaly (AP) varies independently of bone mineral density (BMD). Body composition parameters, which are altered in patients with acromegaly, are important determinants of bone strength.PurposeThe aim of this study was to examine BMD and lumbar trabecular bone score (TBS) by dual-energy X-ray absorptiometry (DXA) and to assess its relationship with disease activity, age, glucose metabolism, and body composition parameters.MethodsThis cross-sectional prospective study involved 115 patients with acromegaly (70 F, 45 M) and 78 healthy controls (CON) (53 F, 25 M) matched for age, gender, and BMI. Bone mineral density, TBS and body composition parameters were measured using DXA.ResultsAP presented with lower TBS compared to CON (1.2 ± 0.1 v 1.31 ± 0.1, P< 0.001). No significant correlation was observed between IGF-1/GH levels and TBS. Age, glycated haemoglobin, BMI, waist circumference, fat mass, and lean mass negatively correlated with TBS in both sexes. Multiple linear regression analysis of all these parameters revealed age and waist circumference as independent significant predictors of TBS in AP. We did not find difference in BMD (lumbar and femoral sites) between AP and CON nor between active and controlled AP. We observed negative correlation between age and BMD of the femoral neck and total hip (P < 0.001). Testosterone levels in males, BMI, waist circumference, fat mass, and lean mass positively correlated with BMD in AP, with stronger correlation between lean mass and BMD compared to fat mass.ConclusionPatients with acromegaly have lower TBS than controls, confirming impaired bone microarchitecture in acromegaly regardless of BMD. Age, body composition parameters and glucose metabolism contribute to TBS deterioration in AP more than disease activity itself.

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“…Repeated REMS measurements have captured the reduction in BMD, caused by the commencement of AI and the increase in BMD which follows treatment of these patients with denosumab [ 17 ]. REMS effectiveness has also been verified in further single-centre studies of patients with anorexia nervosa or with rare diseases such as osteogenesis imperfecta or acromegaly [ 40 – 42 ].…”

Section: Chronic Disorders Affecting the Skeletonmentioning

confidence: 90%

Radiofrequency echographic multi spectrometry (REMS) in the diagnosis and management of osteoporosis: state of the art

Fuggle,

Reginster,

Al-Daghri

et al. 2024

Aging Clin Exp Res

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Radiofrequency Echographic Multi Spectrometry (REMS) is a radiation-free, portable technology, which can be used for the assessment and monitoring of osteoporosis at the lumbar spine and femoral neck and may facilitate wider access to axial BMD measurement compared with standard dual-energy x-ray absorptiometry (DXA).There is a growing literature demonstrating a strong correlation between DXA and REMS measures of BMD and further work supporting 5-year prediction of fracture using the REMS Fragility Score, which provides a measure of bone quality (in addition to the quantitative measure of BMD).The non-ionising radiation emitted by REMS allows it to be used in previously underserved populations including pregnant women and children and may facilitate more frequent measurement of BMD.The portability of the device means that it can be deployed to measure BMD for frail patients at the bedside (avoiding the complications in transfer and positioning which can occur with DXA), in primary care, the emergency department, low-resource settings and even at home.The current evidence base supports the technology as a useful tool in the management of osteoporosis as an alternative to DXA.

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Bone densitometry by radiofrequency echographic multi-spectrometry (REMS) in acromegaly patients

Cited by 10 publications

References 33 publications

Trabecular Bone Score and Osteoprotegerin as Useful Tools in the Assessment of Bone Deterioration in Acromegaly

Trabecular Bone Score and Osteoprotegerin as Useful Tools in the Assessment of Bone Deterioration in Acromegaly

Age, body composition parameters and glycaemic control contribute to trabecular bone score deterioration in acromegaly more than disease activity

Radiofrequency echographic multi spectrometry (REMS) in the diagnosis and management of osteoporosis: state of the art

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