Why does osteopenia happen in acromegaly? I thought you should have increased bone growth with more GH.
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Step I Acromegaly: Osteopenia why?
Started by lemonade90
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The first hit you get in google on the subject is titled "Osteopenia occurs in a minority of patients with acromegaly and is predominant in the spine." Some sources are saying it's associated with a deficiency in basophilic FSH cells and low estrogen, but I wouldn't expect to see it on STEP 1 since it's seen in a minority of a minority. I don't think it's characteristic of acromegaly in general.
Based on:
Prevalence of osteoporosis and vertebral fractures in acromegalic patients -- Giuseppina Padova,1 Graziella Borzì,1 Laura Incorvaia,1 Guido Siciliano,2 Valentina Migliorino,1 Mario Vetri,1 and Patrizia Tita1
They say:
"A chronic GH and IGF-1 excess produces an increased bone turnover, reflected in an increase of bone formation and resorption markers; bone resorption markers are disproportionately increased respect bone formation markers and their increase could reflect the degree of bone loss often observed."
And btw, nowhere in the article were they any more specific than that. If anyone wants to delve into the actual mechanism, I'd be more than happy to hear as well.
Prevalence of osteoporosis and vertebral fractures in acromegalic patients -- Giuseppina Padova,1 Graziella Borzì,1 Laura Incorvaia,1 Guido Siciliano,2 Valentina Migliorino,1 Mario Vetri,1 and Patrizia Tita1
They say:
"A chronic GH and IGF-1 excess produces an increased bone turnover, reflected in an increase of bone formation and resorption markers; bone resorption markers are disproportionately increased respect bone formation markers and their increase could reflect the degree of bone loss often observed."
And btw, nowhere in the article were they any more specific than that. If anyone wants to delve into the actual mechanism, I'd be more than happy to hear as well.
Based on what ijn posted, it could be that the low estrogen is creating an "osteoporosis type" state. This is definitely plausible as the enlarged GH producing cells could cause atrophy of the remaining pituitary and decrease FSH.
Based on what Phloston posted you could possibly get something akin to have constant PTH (i.e. low levels increase resorption but continuous levels are used to prevent resorption) or the way constant GnRH is used in contraceptives vs the normal pulsatile situation...periodic GH as in the normal case could result in increased bone growth while continous GH as in acromegaly could result in bone resorption.
Don't know, but thanks for the insights. I saw this on a Webpath image FYI and was like WTF.
Based on what Phloston posted you could possibly get something akin to have constant PTH (i.e. low levels increase resorption but continuous levels are used to prevent resorption) or the way constant GnRH is used in contraceptives vs the normal pulsatile situation...periodic GH as in the normal case could result in increased bone growth while continous GH as in acromegaly could result in bone resorption.
Don't know, but thanks for the insights. I saw this on a Webpath image FYI and was like WTF.
