Endocrine Abstracts

JOINT4043

Introduction: Acromegaly is a rare endocrine disorder associated with a wide range of comorbidities, including cardiovascular disease, metabolic disorders, and musculoskeletal complications. Surgical resection of the pituitary tumor is the primary treatment, and achieving long-term remission can significantly improve clinical outcomes. However, the impact of remission on pre-existing comorbidities and the development of new complications after surgery is variable.

Objective: This study aims to evaluate the resolution of comorbidities after achieving long-term acromegaly remission following surgical intervention.

Methods: Retrospective study of all surgically treated acromegaly patients followed at our center from 1992 to 2024. GH and IGF-1 levels were assessed to evaluate acromegaly remission. Resolution of each comorbidity was defined if it was controlled without requiring pharmacological treatment.

Results: Fifty-two patients with acromegaly were included, with 28 (54%) females. The mean age at diagnosis was 46 years, with a mean symptom duration of 6 years. The median follow-up was 7 years. Comorbidities were reported in most patients, including hypertension in 25 (48%), arthropathy in 16 (31%), type 2 diabetes (T2D) in 12 (23%), obstructive sleep apnea in 5 (10%) and colon polyps in 8 (15%). All patients underwent surgery and one-year postoperative biochemical remission was found in 21% of patients (8/39). Among patients who achieved remission, pre-surgery comorbidities included dyslipidemia in 38% (3/8), hypertension in 50% (4/8), T2D in 25% (2/8), and obstructive sleep apnea in 25% (2/8). Currently, with a mean follow-up of 10 years, resolution of comorbidities was observed in 33% (1/3) for dyslipidemia, 100% (2/2) for T2D, and 100% (2/2) for obstructive sleep apnea. No new comorbidities developed during follow-up.

Conclusions: Treating patients with acromegaly may improve associated comorbidities such as T2D, obstructive sleep apnea and dyslipidemia. Nevertheless, only a limited number of comorbidities can show full reversibility, emphasizing the need for early diagnosis and intervention to prevent long-term complications.