Endocrine Abstracts

Background: Acromegaly is characterized by disabling symptoms and relevant comorbidities. Insulin resistance, leading to glucose intolerance is one of the most important contributory factor to the cardiovascular mortality in acromegaly.

Aim: To assess the impairments of glucose homeostasis in acromegalic patients and find association between activity of the disease and the severity of glucose intolerance.

Patients and methods: In this retrospective study, we analyzed records of 220 patients (138 females – 62.27% and 83 males – 37.73%) with untreated acromegaly diagnosed at our Department in the years 1994–2006. Diagnosis of active acromegaly was established on the basis of elevated plasma GH above 1 ug/l during the 75 g OGTT and elevated plasma IGF-1 above normal range for age and gender. The patients with overt diabetes mellitus did not undergone the test. The abnormalities in plasma glucose concentrations were categorized according to WHO criteria.

Results: In the studied group, the mean age at the moment of diagnosis was 46.28±13.82 years. The duration of the disease since the onset of the first symptoms was 7.50±4.97 years.

Normoglycemia existed in 45.52% of acromegalic patients. Among glucose tolerance abnormalities we found impaired fasting glucose (IFG) in 20%, impaired glucose tolerance (IGT) in 5.52%, both IFG and IGT in 6.90% and overt diabetes mellitus in 22.07%. There was no statistically significant difference in basal plasma GH and IGF-1 concentrations between normoglycemic patients and with impairments in glucose tolerance. The groups statistically significantly differed when the age of diagnosis was concerned (P=0.038). There was no significant correlation between fasting plasma glucose and GH, IGF-1 concentrations.

Conclusions: The frequency of diabetes was four times higher in acromegalics than in general Polish population which should urge clinicians to treat this disease not only to reduce growth factors, but also to maintain the favorable effects on metabolism and metabolism-related mortality.