AUTHOR=Kužma Martin , Vaňuga Peter , Pávai Dušan , Killinger Zdenko , Hans Didier , Binkley Neil , Payer Juraj , Jackuliak Peter 

TITLE=Association of trabecular bone score corrected for tissue thickness with glucose metabolism in acromegaly

JOURNAL=Frontiers in Endocrinology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1448566

DOI=10.3389/fendo.2024.1448566

ISSN=1664-2392

ABSTRACT=<sec><title>Introduction</title><p>Acromegaly is associated with increased vertebral fracture (VF) risk regardless of bone mineral density (BMD). However, the vertebral trabecular compartment is still low; a possible contributor to this may be impaired glucose metabolism (GM) which frequently complicates acromegaly. Additionally, soft tissue thickness may confound bone imaging in acromegaly patients.</p></sec><sec><title>Objective</title><p>This study aims to assess the association of GM with BMD, trabecular bone score adjusted for BMI (TBS<sub>BMI</sub>), and trabecular bone score adjusted for tissue thickness (TBS<sub>TT</sub>) among acromegaly subjects.</p></sec><sec><title>Patients and methods</title><p>A cross-sectional study was performed among 70 consecutive acromegaly patients (24 male/46 female, aged 55.1 years) divided in two subgroups: abnormal GM (<italic>n</italic> = 35) and normal GM (<italic>n</italic> = 35). Using DXA, BMD, TBS<sub>BMI</sub>, TBS<sub>TT</sub>, and VF screening were performed.</p></sec><sec><title>Results</title><p>In all subjects, TBS<sub>TT</sub> was higher (mean 9.5%) than TBS<sub>BMI</sub>. Abnormal GM subjects had lower TBS<sub>BMI</sub> (1.166 ± 0.15) than normal GM subjects (1.232 ± 0.12; <italic>p</italic> &lt; 0.05). No between-group difference in TBS<sub>TT</sub> or BMD was observed. In a multiple regression model, the best predictor of TBS<sub>TT</sub> was HbA1c (<italic>p</italic> = 0.002). None of the DXA measures or GM parameters was a significant predictor of VF (<italic>n</italic> = 7).</p></sec><sec><title>Conclusion</title><p>The abnormal GM acromegaly subjects had lower TBS<sub>BMI</sub> than those with normal GM. TBS<sub>TT</sub> was higher than TBS<sub>BMI</sub>, and no between-group difference based on GM status was observed. TBS<sub>TT</sub> was significantly associated with GM parameters, notably HbA1c. The relationship of TBS<sub>TT</sub> with GM parameters may imply an effect of GM on trabecular bone microstructure in patients with acromegaly; a further study is indicated.</p></sec>