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Increased Cortical Bone Content of Insulin-Like Growth Factors in Acromegalic Patients¹

Department of Endocrinology, National University Hospital (T.U., J.B., O.D.), N-0027 Oslo, Norway; the Department of Endocrinology, Odense University Hospital (T.B.H., E.N.E.), DK-5000 Odense, Denmark; and the Department of Cell Biology, University of Aarhus (L.M.), and the Department of Endocrinology (K.B.) and the Medical Research Laboratory M (A.F.), Aarhus University Hospital, DK-8000 Aarhus, Denmark

Address all correspondence and requests for reprints to: Dr. Thor Ueland, Department of Endocrinology, National University Hospital, N-0027 Oslo, Norway.

To investigate cortical bone composition and the role of the insulin-like growth factor (IGF) system in active acromegaly, iliac crest bone biopsies were obtained from 15 patients (3 women and 12 men), aged 21–64 yr (mean, 45.6 yr), and 25 age- and sex-matched controls (8 women and 17 men), aged 22–66 yr (mean, 44.6 yr). Levels of IGF-I, IGF-II, IGF-binding protein-3 (IGFBP-3), IGFBP-5, and total protein were determined in extracts obtained after ethylenediamine tetraacetate and guanidine hydrochloride extraction. Osteocalcin and calcium were determined in extracts after HCl hydrolysis. Cortical bone contents of IGF-I, IGF-II, and IGFBP-5 were significantly elevated in the acromegalic patients compared with control values [91% (P < 0.001), 44% (P < 0.04), and 115% (P < 0.004), respectively]. There was no significant difference in IGFBP-3, osteocalcin, protein, and calcium between patients and controls. This study suggests that the increased levels of growth factors in cortical bone from acromegalics is a reflection of local production, secondary to a chronic systemic excess of GH and IGF-I.

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