PURPOSE Bone health is compromised in acromegaly resulting in vertebral fractures (VFs), regardless of biochemical remission. Sclerostin is a negative inhibitor of bone formation and is associated with increased fracture risk in the general population. Therefore, we compared sclerostin concentrations between well-controlled acromegaly patients and healthy controls, and assessed its relationship with bone mineral density (BMD), and VFs in acromegaly. METHODS Seventy-nine patients (mean age 58.9 ± 11.4 years, 49% women) with controlled acromegaly, and 91 healthy controls (mean age 51.1 ± 16.9 years, 59% women) were included. Plasma sclerostin levels (pg/mL) in patients were measured with an ELISA assay, whereas in controls, serum levels were converted to plasma levels by multiplication with 3.6. In patients, VFs were radiographically assessed, and BMD was assessed using dual X-ray absorptiometry. RESULTS Median sclerostin concentration in controlled acromegaly patients was significantly lower than in healthy controls (104.5 pg/mL (range 45.7-234.7 pg/mL) vs 140.0 pg/mL (range 44.8-401.6 pg/mL), p < 0.001). Plasma sclerostin levels were not related to age, current growth hormone (GH) or insulin-like factor-1 (IGF-1) levels, gonadal state, treatment modality, remission duration, or BMD, VF presence, severity or progression. CONCLUSION Patients with long-term controlled acromegaly have lower plasma sclerostin levels than healthy controls, as a reflection of decreased osteocyte activity. Further longitudinal studies are needed to establish the course of sclerostin during different phases of disease and its exact effects in acromegalic osteopathy.

中文翻译：

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肢端肥大症长期缓解后的低硬化蛋白水平。

目的 无论生化缓解如何，肢端肥大症都会损害骨骼健康，导致椎骨骨折 (VFs)。硬化蛋白是骨形成的负抑制剂，与普通人群骨折风险增加有关。因此，我们比较了控制良好的肢端肥大症患者和健康对照组之间的硬化蛋白浓度，并评估了它与肢端肥大症患者骨矿物质密度 (BMD) 和 VF 的关系。方法 包括 79 名肢端肥大症得到控制的患者（平均年龄 58.9 ± 11.4 岁，49% 女性）和 91 名健康对照者（平均年龄 51.1 ± 16.9 岁，59% 女性）。患者的血浆硬化蛋白水平 (pg/mL) 用 ELISA 测定法测量，而在对照组中，血清水平通过乘以 3.6 转换为血浆水平。在患者中，对 VF 进行了放射学评估，使用双 X 射线吸收测定法评估 BMD。结果 受控肢端肥大症患者的中位硬化素浓度显着低于健康对照组（104.5 pg/mL（范围 45.7-234.7 pg/mL）与 140.0 pg/mL（范围 44.8-401.6 pg/mL），p < 0.001）。血浆硬化蛋白水平与年龄、当前生长激素 (GH) 或胰岛素样因子-1 (IGF-1) 水平、性腺状态、治疗方式、缓解持续时间或 BMD、VF 存在、严重程度或进展无关。结论长期控制肢端肥大症患者的血浆硬化蛋白水平低于健康对照组，这反映了骨细胞活性降低。需要进一步的纵向研究来确定硬化素在疾病不同阶段的过程及其在肢端肥大症骨病中的确切作用。