SynthesisPituitary2022
Determinants of skeletal fragility in acromegaly: a systematic review and meta-analysis.
Synthesis in Pituitary, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Differences between bone health parameters in adults with acromegaly and growth hormone deficiency: A systematic review.Best practice & research. Clinical endocrinology & metabolism · 2023Pooled it
- Proteomic profile of bone in patients with acromegaly: new insights from a pilot exploratory study.Journal of endocrinological investigation · 2026Article
- Bone and joint quality remains impaired in long-term controlled acromegaly: an HR-pQCT study.Journal of the Endocrine Society · 2026Article
- The acromegaly patient experience: burden of treatment and quality of life.The Journal of clinical endocrinology and metabolism · 2026Review
- Osteoporosis and fragility fractures in patients with acromegaly: A two-center cross-sectional study.World journal of orthopedics · 2025Article
- Review
- New insights into the vitamin D/PTH axis in endocrine-driven metabolic bone diseases.Endocrine · 2024Review
- DXA-derived lumbar bone strain index corrected for kyphosis is associated with vertebral fractures and trabecular bone score in acromegaly.Endocrine · 2024Article
- Diagnosis and therapeutic approach to bone health in patients with hypopituitarism.Reviews in endocrine & metabolic disorders · 2024Review
- Long-term Pegvisomant Therapy of Acromegaly: Effects on Bone Density, Turnover and Microstructure Using HRpQCT.Journal of the Endocrine Society · 2024Article
- Acromegaly and Bone: An Update.Endocrinology and metabolism (Seoul, Korea) · 2023Review
- Endocortical Trabecularization in Acromegaly: The Cause for the Paradoxically Increased Vertebral Fracture Risk?JBMR plus · 2023Article
- Acromegaly and the long-term fracture risk of the vertebra and hip: a national cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Article
- Persistent Deficits in Bone Quality in Treated Acromegaly: Evidence From Assessments of Microstructure.Journal of the Endocrine Society · 2023Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeVertebral fractures (VFs) are a potential complication in acromegaly. However, the etiology of this skeletal fragility is unknown. This review aimed to evaluate the effect of acromegaly on VFs, bone turnover, areal bone mineral density (aBMD), and bone quality/microarchitecture. The effect of disease activity and gonadal status in these determinants of skeletal fragility was also evaluated.
methodsArticles published in English until September 6, 2020 on PubMed and Embase that reported at least one determinant of skeletal fragility in acromegalic patients, were included. Odds ratio (OR) to evaluate the risk of VFs and the standardized mean difference (SMD) to evaluate bone turnover, aBMD and bone quality/microarchitecture were calculated.
resultsFifty-eight studies met eligibility criteria, assembling a total of 2412 acromegalic patients. Of these, 49 studies were included in the meta-analysis. Acromegalic patients, when compared to non-acromegalic patients, had higher risk of VFs [OR 7.00; 95% confidence interval (CI) 2.80-17.52; p < 0.0001], higher bone formation (SMD 1.14; 95% CI 0.69-1.59; p < 0.00001), higher bone resorption (SMD 0.60; 95% CI 0.09-1.10; p = 0.02) and higher aBMD at the femoral neck (SMD 0.36; 95% CI 0.15-0.57; p = 0.0009). No significant differences were found regarding aBMD at lumbar spine. Considering the results of the different techniques evaluating bone quality/microarchitecture, the main reported alterations were a decrease in trabecular bone thickness and density, and an increase in trabecular separation. The presence of active disease and/or hypogonadism were associated with worst results.
conclusionPatients with acromegaly are at increased risk of VFs, mainly because of deterioration in bone microarchitecture.
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