Calcaneal quantitative ultrasound parameters strongly correlate with DXA measurements in patients with acromegaly

Purpose: Patients with acromegaly have increased skeletal fragility. To date, dual-energy X-ray absorptiometry (DXA) and vertebral morphometry are the recommended examinations to evaluate bone health in these patients, despite known limitation. Calcaneal quantitative ultrasound (cQUS) is a less expensive and less invasive method to evaluate bone status compared to DXA. We aimed to investigate bone status by cQUS in a cohort of patients with acromegaly and to evaluate its ability to detect bone impairment. Methods: Observational cohort study including 56 patients with acromegaly (acromegaly group, AG) and 59 healthy subjects matched for age, sex and BMI (control group, CG). DXA and cQUS assessment were performed in both AG and CG; detailed clinical data were collected for the AG. Results: All cQUS parameters showed a good correlation with the DXA-derived T-score values (p<0.001) in both AG and CG. The cQUS-derived T-score was not significantly different in the AG compared to the CG (AG: 0.40 [IQR -1.60 to 1.50]; CG: -1,30 [IQR -1.65 to 0.95], p= 0.068). The cQUS-derived T-score showed a good discriminatory ability for the presence of osteopenia in the AG (AUC 0.833 [CI 0.721-0.945]). This discriminatory ability of the cQUS-derived T-score was similar between the AG and the CG (p=0.325). Conclusions: cQUS parameters showed a good correlation with DXA evaluation in patients with acromegaly, comparable to the observation in the general population. cQUS-derived T-score can accurately discriminate osteopenia in patients with acromegaly.