PTH and acromegaly: The early onset and the irreversibility of VFs requires strict screening and surveillance protocols since the time of acromegaly diagnosis [38, 39], that includes the assay of markers of bone formation and resorption, calcium, vitamin D and parathyroid hormone (PTH), the vertebral morphometry and possibly the analysis of bone microstructure though the trabecular bone score (TBS) and the microindentation technique [40].