Endocrine Abstracts (2017) 49 EP1017 | DOI: 10.1530/endoabs.49.EP1017

Evaluation of upper gastrointestinal system in acromegaly

Pinar Sisman1, Murat Pekgoz2, Mete Sisman3, Soner Cander4, Ozen Oz Gul4, Erdinc Erturk4 & Canan Ersoy4

1Harakani State Hospital, Endocrinology and Metabolism Clinic, Kars, Turkey; 2Sirnak State Hospital, Gastroenterology Clinic, Sirnak, Turkey; 3Muradiye State Hospital, Surgery Clinic, Bursa, Turkey; 4Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey.

Background: Because of prolong exposure to elevated endogenous growth hormone (GH) and insulin-like growth factor (IGF-1) levels in acromegaly, it is resulted in multipl comorbidities such as somatic growth, hypertension, diabetes and sleep apnea. Systemic complications caused by acromegaly include gastrointestinal (GIS) involvement. In our study it was planned to evaluate the upper GIS findings by using endoscopic and ultrasonographic methods in acromegaly patients.

Subjects and methods: Thirty-nine acromegaly patients who had attended to our center for the last 6 months were recruited to the study. Upper GIS endoscopies and abdominal ultrasonography were performed to all patients.

Results: Of the patient included in the study, 23 were male and 16 were female. The mean age of the patients was 51.4±11.0 years. The mean duration of acromegaly was 104.3±88.6 months. Upper GIS endoscopy was performed in 39 patients and hiatal hernia, esophagitis and gastritis, duodenitis or gastric ulser were found in 3 (%7.6), 2 (%1.7) and 31 (%79.4) patients, respectively. In the pathologic evaluation of gastric antrum biopies, intestinal metaplasia was detected in 12 (%30.7) patients and helicobacter pylori was positive in 13 (%33.3) patients. Abdominal ultrasonographic evaluation revealed cholelithiasis findings in 15 (%38.6) patients.

Discussion: As a result of our study, there was no statistically significant difference between age also sex and hiatal hernia, esophagitis, gastroduodenitis, ulcer development in acromegaly patients. Preoperative GH elevation did not affect the development of hiatal hernia, whereas preoperative IGF-1 elevation significantly increased hiatal hernia development. The incidence of developing cholelithiasis was statistically significantly higher in patients with advanced age, long disease duration and no postoperative biochemical control. Limitations of our study are the lack of a control group and the low number of patients. There is a need for controlled studies involving more patients in acromegaly patients.

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