Bone and joint structural impairments in acromegaly

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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.

Timur T. Tsoriev

Author for correspondence.
ORCID iD: 0000-0001-9074-2291
SPIN-code: 7234-2499
Endocrinology Research Centre
Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD, Postgraduate Student (PhD Student), Institute of Clinical Endocrinology, Department of Neuroendocrinology and Bone Diseases

Zhanna E. Belaya
ORCID iD: 0000-0002-6674-6441
SPIN-code: 4746-7173
Endocrinology Research Centre
Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD, PhD, Institute of Clinical Endocrinology, Head of Department of Neuroendocrinology and Bone Diseases

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Supplementary files

Supplementary Files Action
1. The mechanism of realization of anabolic effects of STH and IGF-1 in bone tissue through mechanoreceptors and estrogens. View (182KB) Indexing metadata


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