Bone mineral density and circulating cytokines in patients with acromegaly

S. Longobardi, C. Di Somma, F. Di Rella, N. Angelillo, D. Ferone, A. Colao, B. Merola, G. Lombardi

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Acromegalic patients present an increase of osteoblastic and osteoclastic activity, showing a different effect on the axial and appendicular skeletal structures. At this regard controversial data about bone mineral density (BMD) have been published in literature. In fact an increase of BMD levels in femoral neck and Ward's triangle without any difference in lumbar spine has been described. On the other hand normal BMD levels at forearm and reduced BMD levels at lumbar spine were found. These patients seem to have a reduction of trabecular BMD similar to postmenopausal osteoporotic patients despite normal or slightly elevated cortical BMD. Recently, it has been described that cytokines, in particular tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1), are implicated in the pathogenetic mechanism of postmenopausal osteoporosis. Taking into account that growth hormone (GH) can increase TNF-α and IL-1 secretion by mononuclear blood cells, the evaluation of possible relationship between the reduced BMD at lumbar spine and circulating cytokines levels was carried out in acromegalic patients. In addition we evaluated the effect of acute octreotide administration on serum TNF-α and IL-1 concentrations. Eleven patients with active acromegaly and eleven healthy age-, sex-, weight- and heightmatched subjects were enrolled in this study. BMD was significantly reduced at lumbar spine (0.80 ± 0.29 g/cm2 vs 1.02 ± 0.11 g/cm2; p <0.01), but not at femoral neck level or at Ward's triangle level (0.92 ± 0.15 g/cm2 vs 0.97 ± 0.11 g/cm2, p = NS; and 0.74 ± 0.16 g/cm2 vs 0.85 ± 0.1 g/cm2, p = NS) when compared to controls. Baseline serum levels of TNF-α and IL-1 were in the normal range both in patients and controls. After acute octreotide administration, no differences in circulating TNF-α and IL-1 levels were found. In conclusion, acromegalic patients present a reduced BMD at lumbar spine but not at femoral neck level and Ward's triangle. Circulating cytokines such as TNF-α and IL-1 are in the normal range. These data suggest that cytokines are not involved in the pathogenesis of GH-excess induced osteoporosis. The possibility that the GH excess might affect bone turnover inducing an increase of cytokines acting by a paracrine/autocrine mechanism cannot be ruled out.

Original languageEnglish
Pages (from-to)688-693
Number of pages6
JournalJournal of Endocrinological Investigation
Volume21
Issue number10
Publication statusPublished - 1998

Fingerprint

Acromegaly
Bone Density
Cytokines
Interleukin-1
Tumor Necrosis Factor-alpha
Spine
Femur Neck
Octreotide
Reference Values
Hand Bones
Postmenopausal Osteoporosis
Bone Remodeling
Serum
Forearm
Growth Hormone
Osteoporosis
Blood Cells
Weights and Measures

Keywords

  • Acromegaly
  • Bone
  • IL-1
  • Osteoporosis
  • TNF-α

ASJC Scopus subject areas

  • Endocrinology

Cite this

Longobardi, S., Di Somma, C., Di Rella, F., Angelillo, N., Ferone, D., Colao, A., ... Lombardi, G. (1998). Bone mineral density and circulating cytokines in patients with acromegaly. Journal of Endocrinological Investigation, 21(10), 688-693.

Bone mineral density and circulating cytokines in patients with acromegaly. / Longobardi, S.; Di Somma, C.; Di Rella, F.; Angelillo, N.; Ferone, D.; Colao, A.; Merola, B.; Lombardi, G.

In: Journal of Endocrinological Investigation, Vol. 21, No. 10, 1998, p. 688-693.

Research output: Contribution to journalArticle

Longobardi, S, Di Somma, C, Di Rella, F, Angelillo, N, Ferone, D, Colao, A, Merola, B & Lombardi, G 1998, 'Bone mineral density and circulating cytokines in patients with acromegaly', Journal of Endocrinological Investigation, vol. 21, no. 10, pp. 688-693.
Longobardi, S. ; Di Somma, C. ; Di Rella, F. ; Angelillo, N. ; Ferone, D. ; Colao, A. ; Merola, B. ; Lombardi, G. / Bone mineral density and circulating cytokines in patients with acromegaly. In: Journal of Endocrinological Investigation. 1998 ; Vol. 21, No. 10. pp. 688-693.
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abstract = "Acromegalic patients present an increase of osteoblastic and osteoclastic activity, showing a different effect on the axial and appendicular skeletal structures. At this regard controversial data about bone mineral density (BMD) have been published in literature. In fact an increase of BMD levels in femoral neck and Ward's triangle without any difference in lumbar spine has been described. On the other hand normal BMD levels at forearm and reduced BMD levels at lumbar spine were found. These patients seem to have a reduction of trabecular BMD similar to postmenopausal osteoporotic patients despite normal or slightly elevated cortical BMD. Recently, it has been described that cytokines, in particular tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1), are implicated in the pathogenetic mechanism of postmenopausal osteoporosis. Taking into account that growth hormone (GH) can increase TNF-α and IL-1 secretion by mononuclear blood cells, the evaluation of possible relationship between the reduced BMD at lumbar spine and circulating cytokines levels was carried out in acromegalic patients. In addition we evaluated the effect of acute octreotide administration on serum TNF-α and IL-1 concentrations. Eleven patients with active acromegaly and eleven healthy age-, sex-, weight- and heightmatched subjects were enrolled in this study. BMD was significantly reduced at lumbar spine (0.80 ± 0.29 g/cm2 vs 1.02 ± 0.11 g/cm2; p <0.01), but not at femoral neck level or at Ward's triangle level (0.92 ± 0.15 g/cm2 vs 0.97 ± 0.11 g/cm2, p = NS; and 0.74 ± 0.16 g/cm2 vs 0.85 ± 0.1 g/cm2, p = NS) when compared to controls. Baseline serum levels of TNF-α and IL-1 were in the normal range both in patients and controls. After acute octreotide administration, no differences in circulating TNF-α and IL-1 levels were found. In conclusion, acromegalic patients present a reduced BMD at lumbar spine but not at femoral neck level and Ward's triangle. Circulating cytokines such as TNF-α and IL-1 are in the normal range. These data suggest that cytokines are not involved in the pathogenesis of GH-excess induced osteoporosis. The possibility that the GH excess might affect bone turnover inducing an increase of cytokines acting by a paracrine/autocrine mechanism cannot be ruled out.",
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AU - Di Somma, C.

AU - Di Rella, F.

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AU - Ferone, D.

AU - Colao, A.

AU - Merola, B.

AU - Lombardi, G.

PY - 1998

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N2 - Acromegalic patients present an increase of osteoblastic and osteoclastic activity, showing a different effect on the axial and appendicular skeletal structures. At this regard controversial data about bone mineral density (BMD) have been published in literature. In fact an increase of BMD levels in femoral neck and Ward's triangle without any difference in lumbar spine has been described. On the other hand normal BMD levels at forearm and reduced BMD levels at lumbar spine were found. These patients seem to have a reduction of trabecular BMD similar to postmenopausal osteoporotic patients despite normal or slightly elevated cortical BMD. Recently, it has been described that cytokines, in particular tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1), are implicated in the pathogenetic mechanism of postmenopausal osteoporosis. Taking into account that growth hormone (GH) can increase TNF-α and IL-1 secretion by mononuclear blood cells, the evaluation of possible relationship between the reduced BMD at lumbar spine and circulating cytokines levels was carried out in acromegalic patients. In addition we evaluated the effect of acute octreotide administration on serum TNF-α and IL-1 concentrations. Eleven patients with active acromegaly and eleven healthy age-, sex-, weight- and heightmatched subjects were enrolled in this study. BMD was significantly reduced at lumbar spine (0.80 ± 0.29 g/cm2 vs 1.02 ± 0.11 g/cm2; p <0.01), but not at femoral neck level or at Ward's triangle level (0.92 ± 0.15 g/cm2 vs 0.97 ± 0.11 g/cm2, p = NS; and 0.74 ± 0.16 g/cm2 vs 0.85 ± 0.1 g/cm2, p = NS) when compared to controls. Baseline serum levels of TNF-α and IL-1 were in the normal range both in patients and controls. After acute octreotide administration, no differences in circulating TNF-α and IL-1 levels were found. In conclusion, acromegalic patients present a reduced BMD at lumbar spine but not at femoral neck level and Ward's triangle. Circulating cytokines such as TNF-α and IL-1 are in the normal range. These data suggest that cytokines are not involved in the pathogenesis of GH-excess induced osteoporosis. The possibility that the GH excess might affect bone turnover inducing an increase of cytokines acting by a paracrine/autocrine mechanism cannot be ruled out.

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