肢端肥大症的骨骼并发症。

IF 1.4 Q3 RHEUMATOLOGY
Reumatologia Pub Date : 2023-01-01 Epub Date: 2023-08-31 DOI:10.5114/reum/169918
Arnika Wydra, Maria Stelmachowska-Banaś, Izabella Czajka-Oraniec
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引用次数: 0

摘要

生长激素(GH)分泌过多是罕见的,通常由垂体功能性肿瘤-生长激素瘤引起。如果发生在儿童和青少年时期、骨骺闭合前或成年后肢端肥大症,它会导致骨骼过度线性生长,并表现为巨人症。GH的过量通过增加胰岛素样生长因子1(IGF-1)直接或间接影响骨代谢。在肢端肥大症中,由于GH和IFG-1的过量产生以及这些激素对骨成骨细胞、骨代谢、生长和密度增加的影响。然而,骨转换加速,导致骨微观结构和强度受损,这可能导致椎骨骨折的风险增加,而与正常骨密度无关。除了骨骼结构的变化外,肢端肥大症还会导致一种与原发性骨关节炎性质不同的退行性关节疾病。此外,肢端肥大症会导致心血管、代谢和呼吸系统并发症,从而严重损害生活质量。在这篇综述中,作者总结了肢端肥大症骨关节疾病的病理生理学、诊断和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Skeletal complications in acromegaly.

Skeletal complications in acromegaly.

Skeletal complications in acromegaly.

Hypersecretion of growth hormone (GH) is rare and typically results from a pituitary functional tumor - somatotropinoma. It leads to excessive linear bone growth and manifests as gigantism if occurring in childhood and adolescence, before the closure of epiphyses or as a acromegaly in adulthood. The excess of GH impacts bone metabolism directly as well as indirectly through increased insulin-like growth factor 1 (IGF-1). In acromegaly as a consequence of overproduction of GH and IFG-1 and the influence of these hormones on bone osteoblasts, bone metabolism, growth and density increase. However, bone turnover is accelerated causing impaired bone microstructure and strength, which may lead to increased risk of vertebral fractures irrespective of normal bone mineral density. Apart from the changes in bone architecture, acromegaly also results in a degenerative joint disease of a different nature than primary osteoarthritis. Moreover, acromegaly leads to cardiovascular, metabolic and respiratory complications, and thus significantly impairs the quality of life. In this review, authors summarize the pathophysiology, diagnosis, and treatment of bone and joint disease in acromegaly.

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来源期刊
Reumatologia
Reumatologia Medicine-Rheumatology
CiteScore
2.70
自引率
0.00%
发文量
44
审稿时长
10 weeks
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