Endocrine Abstracts

Introduction: Acromegaly (ACRO) is a rare disease of an excessive somatic growth and distorted proportions arising from hypersecretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). The aim Of this study is to investigate basic demographic parameters such as the age and gender related features, age at diagnosis of the disease, its clinical manifestations, biochemical control and structure of complications in Ukrainian patients with ACRO in a single neuroendocrinological centre.

Material and Methods: Patients with ACRO: n = 133 [including 47 de novo]: female – 88, male – 45, and retrospective study 133 patients (female – 91, male – 42) who had neurosurgical treatment. Diagnosis of ACRO was based on the Consensus Statement on acromegaly (2018). The levels of PRL, GH and IGF-1 were measured.

Results: The study has established that 88.8% of the overall sample consist of patients aged 31 to 60 years: 26.5%/55.2% (male/female); χ² = 15.47; P = 0.0001. Peak of the ACRO manifestation in the overall sample falls on the age of working efficiency (41.3 ± 12.0) yrs. Analysis of the complaints structure in patients with ACRO was: fatigability (45.5%), asthenia (43.9%), headache (43.9%), and excessive sweating (42.3%). Increasing sizes of hands and feet (60.2%) and in facial features (42.3%), which are specific morphological markers of ACRO, more than 50% of patients consider as age-related. It has been established that pre-nosological period has a linear proportional increase, related with age in patients with ACRO: (R² = 3.4%; P = 0.041) and is also associated with the age of manifestation (R = 0.24; R² = 5.96%; P = 0.007).

Conclusion: Sexual dimorphism of the clinical course ACRO is manifested at a young age at the time of manifestation of the disease and is characterized by a higher secretory activity of GH-secreting adenoma and it greater mass effect in men. Secretory and proliferative activity of the GH pituitary adenoma is associated with the age of the patient at the time of the manifestation of ACRO. High total secretory activity of GH-secreting pituitary adenoma, tumor growth rate, resistance to treatment and predisposition to relapse, which are associated with the young patient at the time of the manifestation of the disease, determine the ‘fast-moving’ flow of ACRO. In elderly patients, the domination of the secretory over the proliferative activity of the GH-pituitary adenoma and the satisfactory sensitivity to the treatment determine the ‘slowly progressive’ clinical course of disease.