Carbohydrate disorders in patients with acromegaly
Maria Kurowska1, Joanna Malicka1, Jerzy S Tarach1, Ewa Kiszczak-Bochynska1 & Jolanta Kijek2
Introduction: Carbohydrate disorders in the form of glucose intolerance or overt diabetes are prevalent and well-documented in acromegalic patients.
Aim: To assess the prevalence of carbohydrate disorders and the correlations between BMI, the duration of the disease, GH and IGF-1 concentrations depending on the stage of progression of glucose intolerance in our acromegalic patients.
Methods: Acromegaly was diagnosed using standards established by the Polish Society of Endocrinology and hyperglycemia was diagnosed according to the recommendations of the Polish Diabetes Association.
Material: A group of 28 patients (21 F; 7 M) aged 3776, mean 58.6±8.6 years, treated between 2000 and 2008. The duration of acromegaly ranged from 3 to 24 years, the mean duration being 10.8±6.8 years. The mean BMI of the whole group was 32.2±5.0 kg/m2.
Results: Carbohydrate disorders were found in 20 patients (13 F; 7 M), i.e. in 71.4% of cases. IFG was diagnosed in 25% cases (seven patients: 4 F, 3M), IGT in 20% (4 patients: 2 F, 2 M) and overt diabetes in 31% of them (nine patients: 7 F, 2 M). The highest mean values of the estimated parameters were found in acromegalic patients with co-occurring diabetes and the lowest ones in patients without carbohydrate disorders (P<0.01). The parameters were, respectively: BMI 35.0±4.8 and 31.0±4.9 kg/m2; the duration of the disease 12.7±7.2 and 9±4.2 years; the GH level 36.4±32.8 and 12.7±29.9 ng/ml and the IGF-1 level 830.7±444.6 and 447.8±254.8 ng/ml. Subgroups of patients with acromegaly and subclinical glucose intolerance disorders did not differ significantly from the group with normal carbohydrate metabolism in terms of the parameters which were examined.
Conclusion: Glucose intolerance in different stages of progression was found in a high percentage of patients with acromegaly. Apart from hormone disorders which are diabetes-specific, diabetes risk factors in acromegaly also include features of metabolic syndrome, such as excessive body mass.