Bone biochemical markers in acromegaly: An association with disease activity and gonadal status

Abstract

Objective: We aim to demonstrate the effect of disease activity and gonadal status on bone biochemical parameters in patients with acromegaly.

Methods: In this cross-sectional,case-control study, 73 patients with acromegaly and 64 healthy controls were included in the study. Acromegaly and control groups, as well as active/controlled acromegaly groupswere compared in terms of alkaline phosphatase (ALP), calcium, magnesium, phosphorus, parathormone (PTH) and 25-OH Vitamin D (25[OH]D), and C-terminal telopeptide of type 1 collagen (CTX). Patients with hypogonadism and normal gonadal status were also compared in terms of these parameters among patients with acromegaly.

Results: The calcium, phosphorus, and CTX were increased in the acromegaly group compared to the control group (p=0.04, p=0.006, and p<0.001, respectively). Age, estimated glomerular filtration rate (eGFR), PTH, and 25(OH)D levels were similar in the acromegaly group and the control group. The ALP, calcium, phosphorus, and CTX were increased in patients with active acromegaly compared to those in remission (p=0.03, p=0.001, p=0.03, and p=0.017, respectively). Age, eGFR, ALP, calcium, and CTX were increased in acromegalic patients with hypogonadism compared in those without hypogonadism (p<0.001, p=0.004, p=0.003, p=0.001, and p=0.009, respectively) while phosphorus, PTH, and 25(OH)D levels were similar between the two groups.

Conclusion: Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels, as well as concomitant hypogonadism, play an active role in calcium and CTX levels, while phosphorus levels are associated only with IGF-1 and GH rather than hypogonadism.

Keywords: Acromegaly; acromegaly disease activity; hypogonadism.