Acromegaly is a systemic disease, characterized by an autonomous overproduction of the growth hormone (GH) and of the insulin growth factor I (IGF-I), which can modulate and regulate bone metabolism (1), increasing bone turnover with the subsequent deterioration of cortical and trabecular bone structures, affecting bone quality and quantity and therefore increased risk of vertebral fractures (VFs) (2). This evidence concerns the gene IGF1 and acromegaly.