Endocrine Abstracts

Introduction: Acromegaly is a rare disease caused by excess production of growth hormone (GH) and is associated with multiple complications. The prevalence of associated complications and the mortality rate are associated with the duration of exposure to elevated GH levels, early diagnosis being imperative. Diagnosis of acromegaly is most frequently late, after several years of evolution, with the development of cardiovascular, respiratory, metabolic complications. The presence of multiple complications in these patients contributes to an increased mortality/morbidity rate and a decreased quality of life.

Methods: The study group included 22 patients with acromegaly (women/men = 15/7), aged 24 to 71 years (50.00 ± 5.32). Patients were diagnosed and monitored at the Endocrinology Clinic in Timișoara between 2000 and present.

Results: The diagnosis was established late, 90.9% of patients had pituitary macroadenoma (preoperative adenoma dimension 25.43 ± 12.50 mm) and 95% had complications of acromegaly at the time of diagnosis. The preoperative GH value was 21.54 ± 25.51 ng/ml and the preoperative IGF-1 value was 666.57 ± 346.10 ng/ml. The average number of years of illness in the studied group was 9.82 ± 5.32 years. The studied group presented multiple complications of acromegaly. Frequency of complications presented in the group: 68.2% left ventricular hypertrophy, 54.5% sleep apnea syndrome, of which 13.6% had mild form, 13.6% had moderate form and 27.3% had severe form, 13.6% artrosic disease, 40.9% splenomegaly, 31.8% type II diabetes, 59.1% decreased glucose tolerance, 72.7% obesity, of which 31.8% grade I, 22.7% grade II and 18.2% grade III, and 8 out of 9 patients who had ophthalmological evaluation presented the narrowing of the visual field. We performed the Pearson correlation test of acromegaly complications with the preoperative GH and IGF-1 values and with the total duration in years of the disease, without statistically significant differences. The normalization of the hormonal parameters in the following years was accompanied by the improvement of the clinical picture and complications, with the improvement of the quality of life.

Conclusion: Early diagnosis and prompt assessment of acromegaly complications contribute to improving the quality of life, reducing complications and decreasing morbidity and mortality in acromegaly.