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Update on vertebral fractures in pituitary diseases: from research to clinical practice

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Abstract

Derangement of pituitary hormone axes can induce changes in bone remodeling and metabolism with possible alterations in bone microarchitectural structure and increased susceptibility to fractures. Vertebral fractures (VFs), which are a hallmark of skeletal fragility, have been described in a very large number of patients with pituitary diseases. These fractures are clinically relevant, since they predispose to further fractures and may negatively impact on patients’ quality of life. However, the management of skeletal fragility and VFs in the specific setting of pituitary diseases is a challenge, since the awareness for this disease is still low, prediction of VFs is uncertain, the diagnosis of VFs cannot be solely based on a clinical approach and also needs a radiological and morphometric approach, the risk of fractures may not be decreased via treatment of pituitary hormone disorders, and the effectiveness of bone-active drugs in this setting is not always evidence-based. This review is an update on skeletal fragility in patients with pituitary diseases, with a focus on clinical and therapeutic aspects concerning the management of VFs.

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  1. Flaminia Carrone and Salvatore Ariano contributed equally to this work.

Authors and Affiliations

  1. Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy

    Flaminia Carrone, Salvatore Ariano, Sara Piccini, Marco Mirani, Andrea Gerardo Lania & Gherardo Mazziotti

  2. Neurosurgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, MI, Italy

    Davide Milani

  3. Department of Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, MI, Italy

    Luca Balzarini

  4. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, MI, Italy

    Andrea Gerardo Lania & Gherardo Mazziotti

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Carrone, F., Ariano, S., Piccini, S. et al. Update on vertebral fractures in pituitary diseases: from research to clinical practice. Hormones 20, 423–437 (2021). https://doi.org/10.1007/s42000-021-00275-5

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