Endocrine Abstracts

Introduction: Previous studies reported increased unfavorable metabolic phenotype in patients with active acromegaly.

Aim of the study: We studied the metabolic phenotype in unselected cohort of 133 patients with active acromegaly (83 female, 62.4%), diagnosed at Clinic of Endocrinology, University Clinical Center, Belgrade, Serbia in the period 2007–2018. Mean age at diagnosis of acromegaly was 50.5±1.2 years and mean BMI was 28.4±0.4 kg/m². Pituitary macroadenoma was diagnosed in 72% of patients (n=96).

Methods: We collected demographic and anthropometric data (weight, height, BMI) at diagnosis of acromegaly, before the operative or medical therapy. We measured concentration of IGF-1, growth hormone (GH), lipids (cholesterol, HDL, LDL, triglycerides) and HbA1c. We measured glycemia and insulin levels during oral glucose tolerance test (OGTT) and calculated area under the curve (AUC) for glycemia and insulin during OGTT, HOMA and Matsuda index of insulin sensitivity (ISI).

Results: In this cross-sectional study, 37.6% of patients were overweight (n=50) and 36.8% of patients were obese (n=49). Prevalence of diabetes mellitus (DM) was 25.6% (n=34) and prevalence of impaired fasting glucose (IFG) plus impaired glucose tolerance (IGT) was 18.0% (n=24). DM, IFG and IGT were more prevalent in females than males (45.7% vs 40.0%). Prevalence of arterial hypertension in the cohort was 62.4% (n=83), hypercholesterolemia 61.7% (n=82), low HDL 18.8% (n=25), high LDL 50.4% (n=67) and hypertriglyceridemia 47.4% (n=63). Arterial hypertension, hypercholesterolemia and hypertriglyceridemia were more common in females compared with males (arterial hypertension: 70.4% vs 47.9%; hypercholesterolemia: 66.7% in females vs 53.3% in males; hypertriglyceridemia: 50.0% in females vs 44.4% in males), while low HDL was more prevalent in males (28.6% vs 12.1%). Statistically significant associations were found between IGF1 or GH levels with baseline glycemia (P=0.004) and insulin (P=0.002), AUCinsulin (P=0.05), HOMA (P=0.001) and ISI (P=0.008).

Conclusions: Unfavorable metabolic phenotype characterized by insulin resistance with high prevalence of hypertension, dyslipidemia and obesity is common in active acromegaly, especially in females.