Endocrine Abstracts

Background: Acromegaly is the consequence of excessive growth hormone (GH) secretion, usually produced by a pituitary adenoma. Transphenoidal surgery is the first-choice treatment; however, the development of new drug therapies in the last years, specially the somatostatin analogues (SSA), has open new and promising avenues for the treatment of pituitary tumors.

Objective: To determine whether a detailed knowledge of the clinico-pathological and radiological characteristics of the acromegalic patients and the adenoma molecular phenotype could help to predict the hormonal response to therapy in order to improve the management of patients with this pathology.

Material and methods: Observational study including patients with acromegaly, diagnosed at the Endocrinology and Nutrition Unit of the Hospital Reina Sofía from 2007 to 2012, in which surgery, radiology and molecular phenotyping of the adenoma was carried out.

Results: 22 patients were included (38±15 years old; 65% women). 3 patients meet cure criteria. These who meet cure criteria have lower triglycerides levels (86±7 mg/dl), more LH (9±10U/L) and FSH (15±20) than those who do not (Tg 128±54, P=0.021; LH 2±1, P=0.019; FSH 3±3, P=0.035). Inferior-posterior diameter was lower in patients who meet healing criteria (15±1 vs 19±7; P= 0.044) and lower antero-posterior diameter (15±1 vs 19±7; P=0.044). There were no differences about comorbidities or symptoms at diagnostic between two groups. Patients who meet cure criteria express more POMPC and GnRHR than those who do not (POMC 2±3 vs 0±0, P=0.036; GnRHR 0.8±0.1 vs 0±0, P=0.034).

Conclusion: Overall, our results indicate that there is a significant correlation between several pre-surgical parameters and the disease cure. Patients who meet cure criteria have lower infero-posterior and antero-posterior diameter; and express more POMPC and GnRHR.