Journal
ENDOCRINE PRACTICE
Volume 28, Issue 5, Pages 515-520Publisher
ELSEVIER INC
DOI: 10.1016/j.eprac.2022.01.011
Keywords
acromegaly; Wnt antagonists; bone turnover markers; growth hormone; insulin-like growth factor 1
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Wnt antagonist levels decrease in patients with active acromegaly and return to normal levels in biochemically controlled patients. This decrease may be a compensatory mechanism for increased bone fragility in active acromegaly.
Objective: The Wnt signaling pathway is an important modulator of bone metabolism. This study aims to clarify the changes in Wnt antagonists in active and biochemically controlled acromegalic patients. Methods: We recruited 77 patients recently diagnosed with acromegaly. Of those, 41 patients with complete follow-up data were included. Thirty healthy patients matched for age, sex, and body mass index served as controls. At baseline and posttreatment, Wnt antagonists (sclerostin [SOST], dickkopfrelated protein 1 [DKK-1], and Wnt inhibitory factor 1 [WIF-1]), bone turnover markers (osteocalcin, procollagen type 1 N-terminal propeptide [P1NP], and C-terminal telopeptide of type 1 collagen [CTX]) and the bone remodeling index were investigated. Results: Acromegalic patients had higher serum osteocalcin, P1NP, and CTX and a higher bone remodeling index than controls (P < .01). Serum SOST, DKK-1, and WIF-1 levels were significantly decreased in patients compared to controls (all P < .01). Serum SOST and WIF-1 levels were negatively correlated with growth hormone levels; SOST levels were positively correlated with WIF-1. After treatment, serum bone turnover markers and the bone remodeling index decreased, while SOST and WIF-1 significantly increased (P .05). DKK-1 levels did not change compared to baseline (P .05). In biochemically controlled patients, SOST and WIF-1 levels and bone turnover markers were restored and did not differ from those of the control participants (all P > .05). Conclusion: Patients with active acromegaly exhibited significantly decreased Wnt antagonist levels. The reduction in Wnt antagonists is a compensatory mechanism to counteract increased bone fragility in active acromegaly. ?? 2022 AACE. Published by Elsevier Inc. All rights reserved.
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