Endocrine Abstracts

Introduction: Acromegaly is a rare condition secondary to the hypersecretion of GH, often by a pituitary adenoma, which can lead to hypopituitarism of varying degrees. Our study aimed to analyze the characteristics of pituitary insufficiency during acromegaly and to search for its predictive factors.

Methods: Retrospective study carried out in the endocrinology department of Charles Nicolles Hospital. We recorded 28 patients with acromegaly over a period of 30 years.

Results: The study included 17 women and 11 men. The mean age at diagnosis of acromegaly was 45.9±13.9 years. Acromegaly was due to a pituitary adenoma in all cases (4 microadenomas and 24 macroadenomas). The average size of the adenomas was 20.4±9 mm. The hormonal assessment showed gonadotropic insufficiency, corticotropic insufficiency, and thyroid insufficiency in 67, 41, and 19% of cases. Thyroid insufficiency was present in 4 women and 1 man. The average size of the adenoma in the affected subjects was 24.8 mm. Gonadotropic insufficiency was present in 10 women and 8 men. The mean size of adenoma in these patients was 23.9±7, 8 mm with a statistically significant difference compared to the unaffected subjects 13, 8±8, 2 mm (P=0.008). GH nadir under OGTT (P=0.03) and tumor size (P<10-3) were significantly higher in patients with corticotropic insufficiency. A positive correlation was found between the number of affected axes with the value of GH nadir under HGPO75 (r=0.611; P=0.001) and the size of the adenoma (r=0.744; P<10-3). The number of affected axes was significantly higher in patients with aggressive adenoma (P=0.031). Age, gender and diagnostic delay did not significantly interfere with the number of pituitary deficient

Conclusion: We concluded that Tumor size, aggressive adenoma and GH nadir are a predictive factors of pituitary insufficiency.