Epicardial fat is a negative predictor of spine volumetric bone mineral density and trabecular bone score in acromegaly

Valassi, Elena; Crespo, Iris; Malouf, Jorge; Viladés, David; Leta, Rubén; Llauger, Jaume; Urgell, Eulàlia; Aulinas, Anna; Marı́n, A.; Biagetti, Betina; Webb, Susan M.

doi:10.1007/s12020-016-0945-2

Cited by 13 publications

(28 citation statements)

References 19 publications

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“…Volumetric BMD measured by QCT is used to determine the bone density of the trabecular compartment independent from the cortical bone and is not influenced by changes in the size of bones. Volumetric BMD was reported to be decreased in acromegaly (124,125), but the value of this finding in predicting VF risk is unknown, in part due to a lack of specific and standardized cut-offs for identifying individuals with osteoporosis. A more accurate evaluation of bone microstructural alterations associated with GH hypersecretion and VFs may be provided by HR-QCT (83,87), but the high cost and increased radiation dose limit their use in clinical practice.…”

Section: Diagnosis Of Osteopathy In Acromegalymentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Bone disorders associated with acromegaly: mechanisms and treatment

Mazziotti

Lania

Canalis

2019

European Journal of Endocrinology

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Growth hormone (GH) and insulin-like growth factor-I (IGF-I) exert physiological actions on the skeleton throughout life, by stimulating longitudinal bone growth in children, the acquisition of bone mass during adolescence and the maintenance of skeletal architecture in adults. When GH and IGF-I are secreted in excess, bone remodeling is enhanced leading to deterioration of bone microstructure and impairment of bone strength. Indeed, acromegaly causes skeletal fragility, and vertebral fractures are reported in a remarkable number of subjects exposed to GH and IGF-I excess. The management of skeletal fragility in acromegaly is a challenge, since the awareness of this complication is low, the prediction of fracture risk is difficult to ascertain, the risk of fractures remains after the control of acromegaly and the effectiveness of bone-active drugs is unknown. This review is an update on bone disorders associated with acromegaly and provides a perspective of possible therapeutic approaches based on emerging pathophysiological and clinical information.

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Section: Diagnosis Of Osteopathy In Acromegalymentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Bone disorders associated with acromegaly: mechanisms and treatment

Mazziotti

Lania

Canalis

2019

European Journal of Endocrinology

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“…One hypothesis is that GH/IGF-1 stimulates the production of cytokines implicated in osteoclast regulation, such as interleukin-6 (29), and tumor necrosis-factor-a (30). In addition, the interaction between osteoclasts and adipocytes with modification of the canonical wingless (Wnt) signaling pathway may play a role (31). Studies in animals and GH-deficient patients suggested the RANK-L/OPG system might mediate the IGF-1 effect on osteoclast (20,21).…”

Section: Bone Metabolism In Acromegalymentioning

confidence: 99%

Calcium and Bone Turnover Markers in Acromegaly: A Prospective, Controlled Study

Constantin

Tangpricha

Shah

et al. 2017

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context: Acromegaly has been associated with calcium-phosphate and bone turnover alterations. Controlled studies of these interactions are sparse.Objective: To evaluate calcium and bone metabolism in active and treated acromegaly.Design/Setting/Patients: We conducted a controlled, prospective study at a tertiary referral center. We studied 22 patients with acromegaly referred for surgical or medical therapy (ACM) and 22 with nonfunctioning pituitary adenomas referred for surgery (control).Main Outcome Measures: Calcium (serum and urine), phosphorus, parathyroid hormone (PTH), 25-hydroxyand 1,25-dihydroxy-vitamin D, bone turnover markers [serum C-terminal telopeptide of type 1 collagen (CTX) and procollagen type 1 N-terminal propeptide (P1NP)], and cytokines [receptor activator of nuclear factor kB ligand (RANK-L) and osteoprotegerin (OPG)] at baseline and 3 to 6 months after treatment.Results: At baseline, the ACM group had lower PTH levels than controls (36.3 6 13.9 pg/mL vs 56.0 6 19.9 pg/mL) and higher phosphorus (4.34 6 0.71 mg/dL vs 3.55 6 0.50 mg/dL) (P , 0.01). Groups had similar levels of serum and urine calcium and 25-hydroxy-and 1,25-dihydroxy-vitamin D. The ACM group had higher bone turnover markers than control; P1NP and CTX were strongly correlated (r 2 = 0.82, P , 0.05). CTX was dependent on age and disease group but not on sex or gonadal status. After treatment of acromegaly, serum calcium (9.52 6 0.43 mg/dL to 9.26 6 0.28 mg/dL), phosphorus (4.34 6 0.71 mg/dL to 3.90 6 0.80 mg/dL), and CTX (0.91 6 0.75 ng/mL to 0.63 6 0.68 ng/mL) decreased, while PTH increased (36.3 6 13.9 pg/mL to 48.9 6 16.7 pg/mL) (P , 0.01). 25-hydroxy-vitamin D, P1NP, and RANK-L/OPG ratio did not change significantly. Conclusion:Acromegaly patients exhibited PTH-independent calcium-phosphate alterations and enhanced coupled bone formation and resorption. Within 6 months of treatment, bone resorption decreased, whereas RANK-L/OPG changes were inconsistent. 2416https://academic.oup.com/jcem

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“… 41 , 42 A recent study showed an inverse relationship between epicardial fat and BMD of lumbar spine in acromegaly patients, which was mediated by Dickkopf-related protein 1 (DKK1), an inhibitor of osteoblast differentiation and bone formation produced by preadiopocytes and osteocytes in humans. 19 However, no studies have evaluated this association in the general population.…”

Section: Discussionmentioning

confidence: 99%

“… 17 , 18 Recent study reported an inverse relationship between EAT and bone mineral density (BMD) in acromegaly patients, no studies have evaluated this association in the general population. 19 …”

Section: Introductionmentioning

confidence: 99%

Epicardial Fat Thickness and Bone Mineral Content: The Healthy Twin Study in Korea

Lee

Cho

Choe

et al. 2018

Journal of Epidemiology

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BackgroundThe conventional concept of positive association between general obesity and bone health was challenged in recent studies reporting the different effects of specific fat deposition on bone health. In the present study, we investigated the association between epicardial fat and bone health.MethodsWe measured echocardiographic epicardial fat thickness (EFT) and bone mineral content (BMC) in a twin-family cohort of Koreans (n = 1,198; 525 men, 460 pre- and 213 post-menopausal women). A total 121 pairs of monozygotic twin (MZ) and 404 pairs of dizygotic twin and sibling pairs (DZ/Sib) were included.ResultsEFT was positively associated with BMC in total, as well as in three subgroups (β = 0.107, 0.076, and 0.058 for men, pre-, and post-menopausal women, respectively). The positive association between EFT and BMC remained for DZ/Sib difference analysis, but was absent for MZ comparisons. The positive association between BMI and BMC was consistent for DZ/Sib and MZ difference analysis. After adjusting for the effect of general obesity via BMI, the association between BMC and EFT was statistically non-significant (β = 0.020, 0.000, and −0.009 for men, pre-, and post-menopausal women, respectively).ConclusionOur findings do not support epicardial fat’s beneficial effects on bone health, whereas general adiposity has an osteotropic effect. The association between EFT and BMC is through common genetic component factors.

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Epicardial fat is a negative predictor of spine volumetric bone mineral density and trabecular bone score in acromegaly

Cited by 13 publications

References 19 publications

MANAGEMENT OF ENDOCRINE DISEASE: Bone disorders associated with acromegaly: mechanisms and treatment

MANAGEMENT OF ENDOCRINE DISEASE: Bone disorders associated with acromegaly: mechanisms and treatment

Calcium and Bone Turnover Markers in Acromegaly: A Prospective, Controlled Study

Epicardial Fat Thickness and Bone Mineral Content: The Healthy Twin Study in Korea

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