Endocrine Abstracts

Introduction: Active acromegaly is reported to be associated with considerable body composition changes, with significant lean body mass changes found only in men.

Patients and methods: In patients with active acromegaly (n=40) 24 females and 16 males, 48.9±6.4 years old, with BMI of 28.04±1.27 kg/m², diagnosed 4.15±1.09 years ago, body composition was analyzed by dual-energy X-ray absorptiometry (DEXA) Hologic-W-QDR. Total body fat mass (FM), total body lean mass (LM), total body fat percent (Fat%), abdominal fat mass (abdFM), abdominal lean mass (abdLM) and abdominal fat percent (abdFat%) were correlated to serum GH and IGF1 values. Gonadal status and replacement therapy were assessed in all patients.

Results: Serum GH in men (30.3±9.4 mIU/l) correlated significantly negatively with Fat% (19.9±6.6%) (R=−0.65 P<0.05). Serum GH in females (49.2±18.1 mIU/l) correlated significantly positively with LM (48.03±7.3 kg, R=+0.48, P<0.05). Serum IGF1 did not correlate significantly with any of the body composition parameters in either gender. Smaller number of included unreplaced hypogonadal male acromegalics (n=4) did not differ in any of the body composition parameters compared to eugonadal male acromegalics (n=9) or hypogonadal patients on testosterone (n=3). Hypogonadal and menopausal women (n=19) exhibited significantly elevated FM (23.1±2.2 vs 19.3±2.1 kg, P<0.01), abdFM (2.8±0.4 vs 2.3±0.3 kg, P<0.01) compared to the smaller number of eugonadal female acromegalics (n=5).

Conclusion: Important body composition parameters (lean body mass, total body fat percent) correlate with GH levels but not with IGF1 in both men and women with active acromegaly. Rutine serum GH level assessment should be added to serum IGF1 determination in the assessment of the acromegaly activity. Gonadal status appears to be of greater confounding influence on body composition in female than in male active acromegalics.