Morphological and bone strength indices in girls with adolescent idiopathic scoliosis and their correlations with leptin and soluble leptin receptor
Journal of Orthopaedic Translation
Purpose: Subjects with acromegaly (AG) suffers of increased bone fragility and, as reported in literature, have a higher prevalence for vertebral fracture even in subjects with normal BMD. Sparse information exists on the effect of AG on bone microarchitecture and no at axial sites. The aim of our study was to examine bone quality and quantity assessed by TBS and BMD in subjects with AG at lumbar spine. Methods: In this longitudinal study 46 subjects with AG have been recruited (26 women and 20
... ed (26 women and 20 men, mean age of 54.9AE11.5 years, BMI of 29.3AE4.2 Kg/ m 2 ). BMD and TBS were evaluated at lumbar spine (LS) using an iDxa DXA device (GE-Lunar) and TBS iNsightâ (v2.1, Med-Imaps, France). Presence of vertebral fracture has been confirmed by Vertebral Fracture Assessment by DXA (VFA). Results: Among all AG subjects, 41% were in active phase of the disease, 74% suffered from hypogonadism (Hy) and 22% sustained at least a fracture (Fx). BMD and TBS showed high correlation (p<0.0001), with 49% of TBS explained by spine BMD. Subjects with Hy have a significant lower BMD and TBS (p<0,002). Those with fracture have a lower TBS (pZ0.02) whereas no difference has been observed on spine BMD (p>0.5). TBS and fracture were associated with an odd-ratio per one SD decrease of 2.64 [1.1-6.3] and an area under the ROC curve of 0,71 [0.56-0,84]. BMD, Age, presence of Hy, or duration of Hy were not associated with the presence of the fracture. Compared to normative TBS value, AG subjects have a significant TBS impairment (-6%, p<0,001). Those with Hy or fracture have a lower TBS values when compared to normative values: -8% (p<0,001) and -13% (p<0,02) respectively. Conclusion: This is the first study reporting changes in BMD and TBS at lumbar spine in subjects with acromegaly. AG induces bone microarchitectural texture impairment at lumbar spine. Presence of hypogonadism or fracture worsens this impairment. As previously obtained, TBS seems to be more sensitive to assess bone architecture impairment than BMD.