Association between Serum Procollagen Type I N-Terminal Propeptide and Bone Metabolism Markers in Iraqi Patients with Acromegaly: A Cross-Sectional Study
DOI:
https://doi.org/10.22401/anjs.29.3.3656Keywords:
Procollagen type 1, 1N terminal propeptide, Vitamin D3, Bone turnover rate, Calcium, Phosphorus, AcromegalyAbstract
Background: Acromegaly is caused by excess secretion of growth hormone (GH) due to a benign pituitary adenoma, which significantly disrupts mineral metabolism and bone turnover. Aims of the study : To compare the serum levels of calcium, phosphorus, 25(OH)D3, and P1NP in patients with acromegaly to those of healthy controls; investigate relationships between P1NP and important metabolic indicators; and use ROC curve analysis to assess P1NP's diagnostic value. Methods: This study is a cross-sectional study, where 60 patients with acromegaly (mean age 46.66 ± 6.75) and 30 age-sex matched healthy controls (mean age 45.10 ± 5.98) were enrolled. The levels of glucose, insulin like growth factor 1 (IGF-1), GH, calcium, phosphorus, 25(OH) D₃, and P1NP were evaluated in the serum. Results: The patients with acromegaly demonstrated significantly higher levels of calcium, phosphorus and P1NP and significantly lower levels of 25(OH)D3 compared with controls. The bone formation (as measured by P1NP) correlated negatively with age (r = –0.26, p < 0.05), indicating that bone formation decreases with age even in the presence of excess GH/IGF-1. The independent variables, phosphate levels, and disease duration were inversely correlated, with a correlation coefficient of –0.29 (p < 0.05), and calcium was positively correlated with the independent variable of phosphate levels, with a correlation coefficient of 0.38 (p = 0.01).ROC analysis of P1NP yielded an AUC of 1.00, indicating strong discriminative ability in this cohort. Conclusion: Changes in bone turnover markers, particularly P1NP, may offer valuable insights into skeletal alterations in acromegaly. While the findings support the potential diagnostic value of P1NP, the cross-sectional design limits causal interpretation. Larger prospective studies are needed to validate these preliminary results and clarify the longitudinal utility of P1NP in clinical practice.
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