Recent experimental studies indicated sexual dimorphism on the skeletal effects of chronic GH and IGF‐1 excess(16) complicated by local GH‐stimulated IGF‐1 and corresponding IGF‐binding protein production.(5, 17) Based on bone mineral density (BMD) measurements of the hip (TH) and femoral neck (FN) by dual X‐ray absorptiometry (DXA), structural information can be derived (hip structure analysis [HSA])(18, 19) and be of importance for understanding the biomechanical competence of the appendicular skeleton and the interplay between the different envelopes in acromegaly.(20). This evidence concerns the gene IGF1 and acromegaly.