Introduction: Acromegaly is a rare disease caused by chronic exposure to excessive levels of GH, usually related to the presence of a pituitary adenoma, and associated to somatic and visceral hypertrophy, metabolic alterations, respiratory and cardiovascular complications, and increased risk of neoplasias.
Materials and methods: The prevalence of manifestations, complications and associated illness was evaluated in 137 acromegalic subjects (52 M, 85 F; age at diagnosis mean±S.D. 51±13.4 years), diagnosed between 1980 and 2011 and followed at our Endocrinology Division, using a specific standard protocol. The study cohort included patients with active disease and cured, treated medically, surgically and/or by radiotherapy. Medical history was collected using electronic medical records and a questionnaire administered to patients.
Results: Data analysis revealed the presence of disease manifestations (carpal tunnel in about 20% of the patients, sleep apnea in 10%, thyroid nodular hyperplasia in 68%) similar to expected and a remarkable rate of complications (hypertension in 55% of the patients, cardiomegaly in 24%, alterations of glucose metabolism in 37%, alterations of lipid metabolism in 44%, decreased bone density in 37%, dolicocolon in 15%, colic diverticulosis in 20%, kidney stones in 23%, gallbladder sludge or stones in 47%) and neoplasias (114 total, mostly affecting gut and genitourinary system). Prevalence of disease manifestations and complications was higher in patients with higher mean GH and IGF1 levels (corrected for age) at diagnosis and follow up, even if the correlation did not reach statistical significance (P>0.005). Prevalence of neoplasias was independent from IGF1, GH and HbA1c levels at diagnosis and follow up, and pituitary tumor size.
Conclusions: Attentive surveillance for manifestations, complications and associated diseases is fundamental at diagnosis and follow up in acromegaly patients, independently from biochemical values, with the aim to provide a prompt diagnosis and treatment.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
05 - 09 May 2012
European Society of Endocrinology