Endocrine Abstracts

Introduction: Acromegaly is a rare condition associated with metabolic abnormalities, risk of cardiovascular complications and increased mortality. Even when biochemical control is achieved, following surgery or medical treatment, patients still complain about disease-related symptoms.

Material and Methods: Retrospective study of acromegaly patients, followed in an Endocrine outpatient clinic. Clinical and biochemical data was recorded. ACRODAT was used to easily understand if patients were controlled, if they were symptomatic or if they had comorbidities [diabetes; cardiovascular disease (CD); sleep apnea] before and after treatment. Symptoms were evaluated by Signs and Symptoms Score (SSS). Surgical cure and biochemical control were considered to be an insulin growth factor-1 (IGF-1) value less than once the upper limit of normal (ULN) for sex and age. Descriptive and inferential statistics were used, with significance level α = 0.05.

Results: Twenty-nine patients were evaluated – mean age = 48 years-old (11–80); mean follow-up time = 63 months (11 – 106). Ten patients achieved disease control following surgery. First evaluation, before surgery: mean IGF-1 = 2.63 above ULN; 7 patients were symptomatic [median SSS score = 9 (6–18)]; 5 had comorbidities. Last evaluation after surgery: mean IGF-1 = 0.77 above ULN; 2 patients were still symptomatic [median SSS score = 2 (1 – 3) – P = 0.018]; 7 had comorbidities – among these, there was one patient who resolved sleep apnea. Ten patients were controlled with medical therapy, after non-curative surgery. First evaluation, before surgery: mean IGF-1 = 2.88 above ULN; 7 patients were symptomatic [median SSS score = 6 (4 – 25)]; 4 patients had comorbidities. Last evaluation after surgery: mean IGF-1 = 0.78 above ULN; 4 complained about symptoms [median SSS score = 6 (2 – 10) – P = 0.046]; 5 patients had comorbidities – among these, there was a patient with new-onset diabetes, another developed CD and another with complains about sleep apnea. Four patients are waiting for surgery; three are still uncontrolled despitesurgery and medical treatment; two patients have died (one because convulsive crisis and another because of pneumoniae and end-stage renal failure). Because this is a retrospective study, it wasn’t possible to collect data about quality of life.

Conclusions: ACRODAT is a useful tool in the follow-up of acromegaly patients. It allows us to evaluate symptoms in a measurable manner, and to understand better how the disease impairs patients’ lives. It may help making treatment decisions. Another advantage relates to comorbidities: allowing to report the ones that improve and the new-onset diabetes, CD and sleep apnea. With this registry it’s possible to manage better each particular patient.