Endocrine Abstracts

Introduction: Diagnostic delay remains significant among the patients with acromegaly, even though the disease awareness has improved over the years.

Aim: The aim was to investigate the diagnostic delay and symptoms present at diagnosis of acromegaly among the newly-diagnosed patients.

Material and methods: 72 consecutive patients diagnosed with acromegaly between 01.2014 and 12.2021 were evaluated. Division into groups based on: gender, age upon diagnosis (≤30 and >30 years of age) and age at the retrospectively estimated onset of symptoms (≤30 and >30 years of age) was made. Clinical and biochemical data at diagnosis were analyzed with IBM SPSS Statistics ver. 27. The study was approved by local Bioethics Committee.

Results: 63 patients (56.6% females, mean age 41.13+/- 14.03 years) were included in the study. Pituitary tumor was accidentally discovered in 24.2%, the median diagnostic delay was 4 years (IQR 4.0-7.0). There were no statistically significant differences in diagnostic delay, accidental diagnosis between genders and age groups. Acral enlargement was the most frequently reported symptom (90.3% of patients). Headaches, reported by 45.2% patients, were more frequent in females (42.86%) than in males (29.63%)(P=0.031). Snoring was more common among patients with onset >30 years of age than in early onset (28.13% vs 0%, P=0.018). 25.85% patients had visual field impairment due to optic chiasm compression. Menstrual abnormalities were present in 37.14% females; 25.92% males reported decreased libido, with no statistical differences. Those symptoms were more common among patients with onset of symptoms ≤ 30 years of age than in those with later onset (50% vs 21.88%, P=0.041). Hypogonadotropic hypogonadism was more common in males (74.1%) than in females (16.7%)(P<0.001). 42.8% of females and 29.6% of males suffered from hyperprolactinemia. Secondary hypothyroidism was present in 14.28% of women and 18.5% men. Adrenal axis insufficiency was discovered in only 2 males (7.4%). Nobody was diagnosed with diabetes insipidus. There was no statistically significant relationship between the diagnostic delay and any of the symptoms or any of the pituitary axis insufficiency.

Conclusions: In our study, males tend to underreport the symptoms of hypogonadotropic hypogonadism. Menstrual irregularities or decreased libido are more frequently reported in younger age, while headaches are more common in females. Diagnostic delay did not statistically depend on presence of any of the symptoms nor pituitary insufficiency.