Bone and joint structural impairments in acromegaly
https://doi.org/10.14341/probl9305
Abstract
Elevated serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) in patients with acromegaly result in intensified bone turnover, as evidenced by increased levels of bone remodeling markers and higher risk of low-traumatic vertebral fractures. However, it was repeatedly observed that bone mineral density (BMD) is normal or even increased in patients with acromegaly (including the active stage of the disease). Increased secretion of GH/IGF-1 causes structural changes in the vertebrae and peripheral joints (osteophyte formation and cartilage hypertrophy), resulting in pain and various deformities of the articular system. These changes are known under the common name «acromegalic arthropathy». It is quite specific complication of the disease. Skeletal complications of acromegaly can persist even after radical treatment, i.e., their course and progression, presumably, do not necessarily depend on the remission level of the underlying disease. This review summarizes the current understanding of the pathophysiology, clinical presentation, diagnosis, and treatment of osteo-articular complications of acromegaly.
About the Authors
Timur T. TsorievEndocrinology Research Centre
Russian Federation
MD, Postgraduate Student (PhD Student), Institute of Clinical Endocrinology, Department of Neuroendocrinology and Bone Diseases
Zhanna E. Belaya
Endocrinology Research Centre
Russian Federation
MD, PhD, Institute of Clinical Endocrinology, Head of Department of Neuroendocrinology and Bone Diseases
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Tsoriev T.T., Belaya Zh.E. Bone and joint structural impairments in acromegaly. Problems of Endocrinology. 2018;64(2):121-129. https://doi.org/10.14341/probl9305
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