ECEESPE2025 Poster Presentations Pituitary, Neuroendocrinology and Puberty (162 abstracts)
Body mass index does not influence the gh response in the oral glucose tolerance test for the diagnosis of acromegaly
Eider Pascual-Corrales 1 , Arturo Vega-Beyhart 1 , ROCIO Villar Taibo 2 , Maria Dolores Moure Rodriguez 3 , Ana García Cano 4 , Paola Gracia Gimeno 5 , Fernando Guerrero 6 , Miguel Paja 7 , Fernando Cordido 8 , Rogelio García Centeno 9 , Laura Gonzalez Fernandez 9 , Pedro Iglesias 10 , Claudia Lozano-Aida 11 , Edelmiro Luis Menendez Torre 11 & Marta Araujo Castro 1
1Hospital Universitario Ramón y Cajal, Endocrinology & Nutrition, Madrid, Spain; 2Hospital Universitario de Santiago de Compostela, Endocrinology & Nutrition, Santiago de Compostela, Spain; 3Hospital de Cruces, Endocrinology & Nutrition, Bilbao, Spain; 4Hospital Universitario Ramón y Cajal, Biochemistry, Madrid, Spain; 5Hospital Royo Villanova, Endocrinology & Nutrition, Zaragoza, Spain; 6Hospital Universitario de Bellvitge (L’Hospitalet de Llobregat), Endocrinology & Nutrition, Barcelona, Spain; 7Hospital Universitario de Basurto, University of the Basque Country UPV/EHU, Endocrinology & Nutrition, Bilbao, Spain; 8Hospital Universitario de A Coruña, Endocrinology & Nutrition, A Coruña, Spain; 9Hospital Universitario Gregorio Marañón, Endocrinology & Nutrition, Madrid, Spain; 10Hospital Universitario Puerta de Hierro Majadahonda, Endocrinology & Nutrition, Madrid, Spain; 11Hospital Universitario Central de Asturias/Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Endocrinology & Nutrition, Oviedo, Spain
JOINT1884
Introduction: The most recent consensus on acromegaly, established by Giustina A et al., 2024, recommends adjusting nadir GH thresholds in the oral glucose tolerance test (OGTT) according to body mass index (BMI). This is because BMI influences GH suppression, with nadir levels being lower in obese than in lean individuals. Therefore, it is suggested to use BMI-specific thresholds to optimize the diagnosis and treatment of the disease.
Objective: To investigate differences in basal GH levels and in the GH response to the OGTT among acromegalic patients with obesity, overweight, and normal weight.
Methods: A retrospective study of 184 patients with acromegaly treated in 10 tertiary hospitals in Spain was carried out. BMI was calculated and baseline GH levels as well as GH response to OGTT were analyzed.
Results: A total of 184 patients with acromegaly were included (mean age 49 ± 14 years, 59% (n = 108) women). At baseline, 66 patients (36%) had obesity (median BMI: 33.3 kg/m2 [32.0–37.4]), 82 (45%) were overweight (27.4 kg/m2 [26.4–28.7]), and 35 (19%) had normal weight (23.6 kg/m2 [22.3–24.6]). At diagnosis, ULN IGF-1 levels in patients with obesity, overweight and normal weight were 2.2 (1.7 – 3.1), 2.7 (1.9 – 3.7) and 2.0 (1.5 – 2.6), respectively (P = 0.011). Basal GH levels (ng/mL) at diagnosis in these three groups were 4.5 (1.9 – 7.2), 7.6 (3.1 – 11.7) and 12.1 (3.4 – 23.6), respectively (P = 0.002). In the OGTT, the reduction in GH levels from basal to nadir (ng/mL) in patients with obesity, overweight, and normal weight was 0.9 (0.4–1.7), 1.7 (0.3–3.3), and 3.5 (0.5–8.3) respectively (P = 0.016); Tukey P-values: normal weight vs overweight = 0.013, normal weight vs obesity = 0.052, overweight vs obesity = 0.868). BMI was not linearly associated with the absolute decrease from basal GH to nadir (P = 0.209), percentage decrease (P = 0.718) or nadir GH levels (P = 0.261). No significant differences in GH reduction during OGTT were observed between patients with and without type 2 diabetes (P = 0.721) and between patients with micro- and macroadenomas (P = 0.174).
Conclusion: In our cohort of patients with acromegaly, basal GH levels and GH response to the OGTT were similar across obese, overweight and normal-weight groups, regardless of whether they had type 2 diabetes or pituitary tumor size Therefore, BMI-based GH nadir cutoffs in the OGTT may not be necessary for acromegaly diagnosis.
Volume 110
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Endocrine Abstracts
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