Endocrine Abstracts

Introduction: Acromegaly is a chronic disorder caused by growth hormone (GH) hyperproduction which leads to significant morbidity and mortality primarily due to cardiovascular and respiratory complications. Pituitary adenoma is the main cause of GH’s hyperproduction. By current guidelines transsphenoidal surgery (TSS) is the first-line treatment in acromegaly patients.

Aim: To evaluate the results of TSS in acromegaly patients 6 months after surgery.

Materials and methods65 patients (48 women and 17 men), mean age 51.2±11.8 years (range 25–72 years) were enrolled into the study. Majority of our patients (75%) had macroadenomas. Only sixteen patients (25%) had microadenomas. All TSS were performed by one neurosurgeon. 6 months after surgery a nadir serum GH within 2 hours after 75 g of oral glucose and IGF-1 were estimated. Remission of acromegaly was considered as: nadir serum GH<0.4 μg/l after an oral glucose load and age-normalized serum IGF-1 value.

Results: Acromegaly remission was confirmed in 17 (26.1%) patients. Remission was established in 56.2% (9 out of 16) patients with the pituitary microadenomas. Among patients with macroadenomas remission was proved in 16.3% (8 out of 49) cases. Patients with the persisting disease have demonstrated significantly higher initial basal GH level (P<0.006).

Conclusions: According to our data TSS was effective in 26.1% cases. The rather low remission rate was associated with macroadenomas predominance in our study group. Microadenoma presence and low initial basal GH value increased the probability of remission.