{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:27:31Z","timestamp":1783474051485,"version":"3.55.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T00:00:00Z","timestamp":1631664000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to evaluate the bone turnover markers and bone microarchitecture parameters derived from high-resolution peripheral quantitative computed tomography (HR-pQCT) in active and controlled acromegaly patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study involved 55 acromegaly patients from a tertiary hospital (23 males and 32 females, aged 45.0 \u00b1 11.6 years). Firstly, growth hormone (GH), insulin-like growth factor-1 (IGF-1), and markers for bone turnover were assessed. Next, we derived peripheral bone microstructure parameters and volumetric bone mineral density (vBMD) through HR-pQCT. These parameters were compared between acromegaly patients and 110 healthy controls, as well as between 27 active and 28 controlled acromegaly patients. Moreover, the relationship between GH\/IGF-1 and bone microstructure parameters was analyzed through multiple linear regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>As compared with healthy controls, acromegaly patients exhibited elevated cortical vBMD, reduced trabecular vBMD, and increased trabecular inhomogeneity in the distal radius and tibia. While controlled acromegaly patients had slower bone turnover, they did not necessarily have better bone microstructure relative to active patients in intergroup comparison. Nevertheless, multiple regression indicated that higher IGF-1 was associated with lower tibial stiffness and failure load. Additionally, males with higher IGF-1 typically had larger trabecular separation, lower trabecular number, and larger cortical pores in the radius. Moreover, patients with elevated GH typically had more porous cortical bone in the radius and fewer trabeculae in the tibia. However, the compromised bone strength in active patients was partially compensated by increased bone thickness. Furthermore, no significant linkage was observed between elevated GH\/IGF-1 and the most important HR-pQCT parameters such as trabecular volumetric bone density.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Acromegaly adversely affected bone quality, even in controlled patients. As the deterioration in bone microstructure due to prolonged GH\/IGF-1 exposure was not fully reversible, clinicians should be aware of the bone fragility of acromegaly patients even after they had achieved biochemical remission.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.738895","type":"journal-article","created":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T04:37:17Z","timestamp":1631680637000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["The Negative Impacts of Acromegaly on Bone Microstructure Not Fully Reversible"],"prefix":"10.3389","volume":"12","author":[{"given":"Lian","family":"Duan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengmin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin Jie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuelun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbo","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxing","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanze","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengying","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weibo","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.050603","article-title":"Increased Prevalence of Radiological Spinal Deformities in Active Acromegaly: A Cross-Sectional Study in Postmenopausal Women","volume":"20","author":"Bonadonna S","year":"2005","journal-title":"J Bone Miner Res"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-10-1005","article-title":"High Prevalence of Vertebral Fractures Despite Normal Bone Mineral Density in Patients With Long-Term Controlled Acromegaly","volume":"164","author":"Wassenaar MJ","year":"2011","journal-title":"Eur J Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-2695","article-title":"Progression of Vertebral Fractures Despite Long-Term Biochemical Control of Acromegaly: A Prospective Follow-Up Study","volume":"98","author":"Claessen KM","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2937","article-title":"Bone Turnover, Bone Mineral Density, and Fracture Risk in Acromegaly: A Meta-Analysis","volume":"100","author":"Mazziotti G","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2012.06.002","article-title":"Vertebral Fracture Assessment in Acromegaly","volume":"16","author":"Madeira M","year":"2013","journal-title":"J Clin Densitom"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-009-0945-7","article-title":"Assessment of Trabecular and Cortical Architecture and Mechanical Competence of Bone by High-Resolution Peripheral Computed Tomography: Comparison With Transiliac Bone Biopsy","volume":"21","author":"Cohen A","year":"2009","journal-title":"Osteoporos Int"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-4073","article-title":"Acromegaly Has a Negative Influence on Trabecular Bone, But Not on Cortical Bone, as Assessed by High-Resolution Peripheral Quantitative Computed Tomography","volume":"98","author":"Madeira M","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-016-1078-3","article-title":"High-Resolution-Cone Beam Tomography Analysis of Bone Microarchitecture in Patients With Acromegaly and Radiological Vertebral Fractures","volume":"54","author":"Maffezzoni","year":"2016","journal-title":"Endocrine"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2700","article-title":"Endocrine Society. 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