Study of pituitary function in acromegaloidism
Wilfredo Guanipa Sierra1,4, Pablo Fernandez Catalina1, Concepción Páramo Fernández2, Elías Álvarez García2, Amalia Andrade Olivié2, Eduardo Pena3 & Federico Mallo Ferrer4
Acromegaloidism includes clinical features of acromegaly with GH and IGF1 normal levels at baseline and dynamic, without findings of extrapituitary or pituitary tumour. It has been associated with various conditions without a definite pattern. The aim was to evaluate whether there are differences in some hormonal pituitary axis from acromegaloid subjects with respect to acromegalic and healthy subjects. We designed a comparative, multicenter, casecontrol study in three hospitals. It was approved by the local ethics committee. Demographic-anthropometric, clinical and analytical data were obtained in fifteen acromegaloid, fourteen acromegalic (without previous radiotherapy) and twelve control subjects, matched by age and sex. There were no significant differences in age, height, weight or BMI. Was determined by chemiluminescent immunoassay: GH, IGF1, IGFBP3, ACTH, cortisol, TSH, FT4, FT3, PRL, PTH, Vit D25, FSH, LH, TST, SHBG, FAI, Insulin and C-peptide. Were used ANOVA and Student t-test to evaluate parametric variables and KruskalWallis for nonparametric variables. The results show significant differences (P=0.001) in mean TSH: 2.91±1.2 U/ml in acromegaloids (CI95: 2.243.57), 1.18±1.0 uU/ml in acromegalics (CI95: 0.601.76) and 2.22±1.25 U/ml in controls (CI95: 1.423.01). When comparing acromegaloid versus acromegalic subjects differences are more evident (P=0.00027). FT4 levels showed no differences between groups. The FT3 level was higher (P: 0.029) in acromegaloidism (mean: 3.05±0.78 pg/ml) than in acromegaly (2.41±0.67 pg/ml) and also higher (P=0.031) in acromegaloidism than in controls (mean: 2.53±0.34 pg/ml). No differences were found in other axes. These findings suggest that in acromegaloidism there are higher levels from TSH and FT3, meaning an increase in thyroid axis activity.