Endocrine Abstracts

Introduction: Acromegaly is a chronic disease that affects morphology and organ functions. These changes lead to clinically relevant comorbidities. Untreated acromegaly reduces life expectancy by 10 years, mostly due to cardiovascular events, malignancies and respiratory disorders. We present the results of a series of 109 acromegalic patients at a single institution.

Methods: Lung function tests were performed under standardized conditions in patients with acromegaly treated in our outpatient clinic. Normative data was used to compare our patients (measured value) with healthy controls (predicted value); percentage of predicted value was used to perform subgroup analysis. Criteria of cure were IGF1 in the age- and sex-adjusted normal range and random GH <1.0 μg/dl.

Results: We investigated 109 acromegalic patients without history of pulmonary disease (53 male, 49%) with a mean age of 54.6 (±13.5) and mean duration of acromegaly of 12.6 years (±11.6). 20 patients had active, untreated acromegaly at time of assessment. 29 patients were biochemically normalized. Lung function significantly differed from healthy controls in terms of higher volume regarding intrathoracal gas volume, maximal vital capacity, residual volume, total lung capacity, and forced expiratory volume in 1 second. Patients showed signs of obstruction with significantly lower peak expiratory flow and maximum expiratory flow when 75% of the FVC has been exhaled (FEF75/MEF25). 56.5% of patients had a reduced FEF75/MEF25 and 40.4% increased residual volume. There was no significant difference between active and inactive acromegaly. Female patients had significantly smaller flow rates of peak expiratory flow, FEF25/MEF75 and FEF50/MEF50.

Conclusions: In our cross-sectional analysis of lung function in 109 patients with acromegaly lung function volumes were increased compared to healthy controls. Patients showed signs of small airway obstruction at time of diagnosis, unchanged in remission. Subclinical airway obstruction was significantly more pronounced in female patients.