Bone Health in Acromegaly.

Skeletal fragility is a complication of acromegaly closely related to hypersecretion of growth hormone (GH) and insulin-like growth factor-1. In this condition, altered-bone remodeling causes deterioration of bone microstructure and impairment of bone strength, resulting in a high risk of vertebral fractures. The management of skeletal fragility in acromegaly might be a challenge since prediction of fractures is difficult, biochemical control of GH hypersecretion does not restore normal bone structure in most of patients, and the efficacy of bone-active drugs in this clinical context is unknown. This article deals with emerging pathophysiologic, clinical, and therapeutic aspects of acromegalic osteopathy.