Endocrine Abstracts

Introduction: The group of young adults with acromegaly, despite initial reports about their aggressive course of disease, has not been thoroughly characterized.

Aim: Our aim was to investigate the differences between the patients with early-onset acromegaly and with onset in older age.

Material and methods: Consecutive patients diagnosed with acromegaly between 01.2014 and 12.2021 were included in this retrospective study, approved by the local Bioethics Committee. Firstly, the arbitrary division (Group A: with patients ≤30 and Group B: with patients >30 y.o. upon diagnosis) was used. Secondly, retrospective estimation of age upon symptoms onset divided the patients into Group C and D (≤30 and >30 y.o. at the onset, respectively). We statistically compared Groups A and B and subsequently Groups C and D in terms of clinical, biochemical and radiological parameters, using IBM SPSS Statistics, ver. 27.

Results: Out of 72 consecutive patients with acromegaly, 64 were included in the study. Group A consisted of 11 patients, 54.5% males, Group B had 53 patients, 41.5% males. Retrospective estimation of the age at diagnosis was available in 50 patients: there were 18 patients in Group C (44.4% males) and 32 patients in group D (34.4% males). There were no statistically significant differences between group A and B as well as between C and D in terms of: gender, median diagnostic delay, frequency of accidental diagnosis, hypopituitarism, hyperprolactinemia and, radiologically, occurrence of macroadenomas, median maximal tumor diameter, pituitary apoplexy, cavernous sinus invasion, compression of the optic chiasm. Median growth hormone (GH) nadir concentration was higher in Group A than in Group B: 38.4 uIU/ml(24.1; IQR 65.7) vs. 20.8 uIU/ml(10.45; IQR 34.5), respectively (P=0.046). GH was higher in Group C(37.7 uIU/ml, IQR 67.2) than in Group D(15.3 uIU/ml, IQR 27.7) (P=0.046). No differences in IGF-1 concentration related to upper normal limit were discovered between the groups in both steps of the analysis. Biochemical control was after surgery was similarly frequent in groups A and B; and groups C and D.

Conclusions: In our study, patients with early-onset acromegaly did not statistically differ from typical-onset patients, even when considering two division criteria: arbitrary and based on the estimated symptoms onset. Our main limitation is the small number of patients enrolled, even though all of the newly diagnosed patients in a tertiary endocrinology center over 8 years were included. Further, prospective studies are needed to identify and assess the differences between age groups of acromegaly patients.