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Pretreatment Insulin-Like Growth Factor-I Concentrations Predict Radiographic Osteoarthritis in Acromegalic Patients with Long-Term Cured Disease

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J Clin Endocrinol Metab Biermasz et al. 94 (7): 2374. (105K)

Pretreatment Insulin-Like Growth Factor-I Concentrations Predict Radiographic Osteoarthritis in Acromegalic Patients with Long-Term Cured Disease

N. R. Biermasz1, M. J. E. Wassenaar1, A. A. van der Klaauw, A. M. Pereira, J. W. A. Smit, F. Roelfsema, R. Wolterbeek, H. M. Kroon, M. Kloppenburg and J. A. Romijn Departments of Endocrinology and Metabolic Diseases (N.R.B., M.J.E.W., A.A.v.d.K., A.M.P., J.W.A.S., F.R., J.A.R.), Epidemiology (M.K.), Rheumatology (M.K.), Radiology (H.M.K.), and Medical Statistics (R.W.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands Address all correspondence and requests for reprints to: N. R. Biermasz, M.D., Ph.D., Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands. E-mail: Dit e-mailadres wordt beveiligd tegen spambots. JavaScript dient ingeschakeld te zijn om het te bekijken. Dit e-mailadres is beschermd tegen spambots. U heeft JavaScript nodig om het te kunnen zien. . Objective: The aim of the study was to identify factors influencingthe development of osteoarthritis during long-term control ofacromegaly, focusing on disease-specific parameters, GH andIGF-I concentrations, and duration of disease, adjusted forthe well-known determinants of primary osteoarthritis.Design: We conducted a follow-up study.Methods: We studied 67 patients with adequate biochemical controlof acromegaly for a mean of almost 13 yr. Study parameters werethe results of radiological assessment of the spine, hip, knee,and hand. Osteoarthritis was defined as radiological osteoarthritisusing the scoring system developed by Kellgren and Lawrence.Correlations between potential factors of influence and osteoarthritiswere performed by analysis of covariance and adjusted for age,gender, and body mass index.Results: Patients with pretreatment IGF-I SD scores in the highesttertile had an almost 4-fold increased risk for radiologicalosteoarthritis of the hip when compared with patients in thelowest tertile. After adjustment for age, gender, BMI, and diseaseduration, pretreatment IGF-I SD scores predicted radiographicosteoarthritis in all joint sites. Osteoarthritis was not predictedby other factors, including pretreatment GH levels, type oftreatment, and duration of follow-up.Conclusion: This is the first study to document pretreatmentIGF-I concentration as a predictor of radiographic osteoarthritisin acromegalic patients with long-term disease control.