Endocrine Abstracts

Introduction: Acromegaly, a rare disorder resulting of tumor GH excess, is frequently associated with prognathism and facial dysmorphia. Characteristics and mechanisms responsible for the malocclusion and the craniofacial changes in acromegalic patients (ACR) are not clarified.

Aims: To evaluate the craniofacial changes in an acromegalic group.

Methods: We observed 59 individuals, 33 with ACR and 26 controls with nonfunctioning pituitary adenomas (NFA) matched for age and sex. Craniofacial skeletal variables related to the cranial base, maxilla and jaw assessment was performed through a basic graphics program Nemoceph.

Results: The mandibular length was significantly higher in ACR (71.8±6.6 mm) than in NFA (NFA 67.4±5.0 mm, P=0.007). We observed a significant correlation between the length of the skull base and mandibular length, both in ACR (r=0.42, P=0.01), and NFA (r=0.46, P=0.01). We found a significant correlation between GH levels and jaw length in ACR (r=0.357, P=0.05). The IGF1, expressed as % upper limit of normal, was significantly correlated with the skull and jaw length and with borderline significance with mandible length (r=0.351, p<0.05/r=0.377, P=0.033/r=0.334, P=0.06 respectively). GH levels did not correlate with other cephalometric parameters, however we observed a statistically significant relationship between the amount of IGF1 and mandibular length adjusted to delayed diagnosis. The ACR have a mean convexity smaller than ANF (2.30±5.66 vs 4.62±3.25 mm, P=0.106), which may represent an effective growth at the level of the chin. In our study, GH hypersecretion was associated with an increase in mandibular length, probably by stimulation of growth at chin level, also considered an extremity.

Conclusion: GH and IGF1 excess induce craniofacial changes. The role of normalization of the GH/IGF1 in the reduction of these comorbidities needs to be evaluated.

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 research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.