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The bone mineral density in our patient was frankly low compared to subjects of the same age; probably, both an earlier diagnosis of the underlying disease and the prompt sex hormone substitution therapy would have prevented the development of osteopenia or, at least, of osteoporosis.
The inclusion criteria were as follows: (1) adult patients who presented characteristic clinical manifestations of acromegaly [17, 18]; (2) patients who satisfied the diagnostic endocrine standard [17] (fasting GH > 1ng/ml, minimum GH > 0.4 ng/ml after oral administration of 75 g of glucose, and a fasting IGF-1 level higher than the age-related reference range); (3) patients with contrast-enhanced MRI of the sellar region indicating a pituitary adenoma; (4) patients who had never received pituitary surgery, irradiation, or medical treatment to reduce the GH and IGF-1 levels; and (5) patients, including patients with gonadotropic hormone substitution, with other pituitary-related hormones at the normal reference levels.

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