Bone metabolism and body composition in Japanese patients with active acromegaly

OBJECTIVE Skeletal Involvement is a common clinical feature in acromegalic patients. Although several recent reports are available concerning bone min eral density (BMD) in acromegaly, the controversy still exists as to whethe r BMD of acromegalic patients is increased or not. The present study was pe rformed to examine biochemical bone metabolic indices and BMD as well as bo dy composition in 26 Japanese patients with active acromegaly and 26 contro l subjects matched for age, sex, race and height in a cross-sectional study . MEASUREMENTS BMD of the lumbar spine and femoral neck, as well as body comp osition, was measured by dual-energy X-ray absorptiometry. Midradial BMD wa s measured by single-photon absorptiometry. We also determined serum levels of IGF-I, IGFBP-3 and osteocalcin (OC) as well as urinary levels of deoxy- pyridinoline (D-Pyr) and CrossLaps. RESULTS Percent lean body mass was increased and percent fat mass was decre ased in the acromegalic patients compared to control subjects. Serum levels of OC, as well as urinary levels of D-Pyr and CrossLaps, were significantl y higher in acromegalic patients compared to control subjects (9.8 +/- 1.2 vs. 5.7 +/- 0.77 for OC; 11.8 +/- 1.66 vs. 5.0 +/- 0.49 for D-Pyr; 437.6 +/ - 68.4 vs. 156.5 +/- 39.6 for CrossLaps). Z scores of BMD at mid-radius as well as lumbar spine and femoral neck were significantly higher in acromega lic patients compared to control subjects (1.086 +/- 0.311 vs. -0.060 +/- 0 .274 for mid-radius; 1.022 +/- 0.280 vs. 0.319 +/- 0.165 for lumbar spine; 1.292 +/- 0.347 vs. 0.232 +/- 0.264 for femoral neck). CONCLUSIONS The present study revealed that a decrease in percent fat mass and an increase in percent lean body mass were observed in Japanese patient s with active acromegaly. Bone mineral density at all sites and bone metabo lic markers were also increased in acromegaly. The present findings provide additional evidence that the GH/IGF-I axis might play an important role in the maintenance of bone mass as well as the regulation of body composition in Japanese adults.