Endocrine Abstracts

Introduction

Acromegaly is a chronic, slowly progressing disease caused in most cases by growth hormone (GH)- producing pituitary neuroendocrine tumors (PitNETs). This rare disorder is associated with a spectrum of various clinical manifestations and treatment outcomes differ between patients. The aim of this study was to evaluate the impact of age at the onset of symptoms and sex on clinical features, comorbidities, biochemical status at the diagnosis, and the severity of disease.

Methods

This is a one-centre cohort study conducted in 2019 among consecutive adult patients with acromegaly and no family history of PitNETs. Baseline data regarding biochemical and radiological status were collected retrospectively, whereas information concerning diagnostic delay, age at the onset of symptoms, menarche, voice break were collected during a routine visit in the outpatient clinic. Statistical analysis was performed in two subgroups depending on sex and in three subgroups depending on age at the diagnosis.

Results

101 consecutive patients were interviewed in the outpatient clinic (60 women, 41 men) with mean age at the diagnosis 46 years (range 19–75). Male patients presented hypogonadism more frequently than female patients (54.1% vs 25.5%, P < 0.05) whereas the differences between sexes in the occurrence of hyperprolactinemia and macroadenomas were not statistically significant. The occurrence of hypogonadism positively correlated with tumour size and negatively correlated with remission of the disease after the first surgery. Baseline IGF-1 level above the upper limit of age-adjusted normal range level and ACTH level were higher in men than in women(529.1 ± 277.7 vs 399.8 ± 250.6 ng/ml and 53.9 ± 28 vs 38.3 ± 23 pg/ml, respectively). Both basal and nadir GH did not differ between sexes. Among younger patients (≤ 40 years) hyperprolactinemia, hypogonadism and macroadenomas were discovered more frequently at the time of diagnosis than in the middle-aged (41–59 years) and in the elderly (≥ 60 years) (P < 0.05). Contrarily, arterial hypertension, nodular goitre and diabetes mellitus or glucose intolerance were more common among elderly patients with acromegaly than in younger age groups (P < 0.05).

Conclusion

According to our results, the course of disease in acromegaly is influenced by patient’s gender and age at the onset of symptoms. These differences should be considered when treating patients with acromegaly.