Endocrine Abstracts

Objective: To know the GH secretory function in surgically cured acromegaly and its impact on quality of life of the patients.

Subjects and methods: Sixty-seven acromegalics were judged to be surgically cured according to the Cortina consensus criteria and underwent postoperative insulin tolerance test (ITT) provoking hypoglycemia with nadir blood sugar under 50 mg/dl. All the patients underwent surgery under combined microscopic and endoscopic observation by skilled pituitary surgeons with experiences of more than 500 transsphenoidal surgeries. The incidence of GH impairment and GH deficiency (GHD) was determined based on the peak GH during ITT. QOL was evaluated by two sets of questionnaire (SF-36 and JAHQ: Japan adult hypopituitarism questionnaire) studies.

Results: The postoperative incidence of impairment of GH secretory function was 6.0% (4/67) for severe GHD; peak GH during ITT <1.8 ng/ml, 6.0% (4/67) for moderate GHD; 1.8 < peak GH<3.0 ng/ml, and 13.4% (9/67) for slightly impaired GH; 3.0<peak GH<6.0 ng/mL. GH secretory function was perfectly preserved, peak GH >6 ng/mL, in 74.6% (50/67) of the subjects. Physical component of SF-36 QOL score of the patients positively correlated with peak GH during postoperative ITT. Both physical function score and social & mental QOL scores of Japan adult hypopituitarism questionnaire (JAHQ) tended to correlate with peak GH during postoperative ITT.

Conclusion: The incidence of GHD (peak GH during ITT <3 ng/ml) was low as 12% in our surgically cured acromegaly. The low incidence seems owing to the sophisticated surgical technique for selective adenomectomy under combined microscopic and endoscopic observation. Considering patients’ QOL positively related to the peak GH during postoperative ITT, pituitary surgeon must pay further attention to preserve pituitary function during adenomectomy.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.