Endocrine Abstracts

Colon polyps represent a frequent complication of acromegaly. Knowledge about prevalence and risk factors of polyps’ recurrence in acromegalic patients is still limited. The current retrospective study aimed at investigating polyps’ prevalence and recurrence risk factors in acromegalic patients. One hundred and forty-three patients (73 males, 70 females) referring to “Federico II” university diagnosed with acromegaly from 2000 to 2022 who underwent at least one colonoscopy have been considered in the present study. Hormonal, metabolic parameters and colonoscopy result were evaluated. Colonoscopy was performed at diagnosis in 104 (72.7%) and after a disease duration of 9.6±5.5 years in 39 patients (27.3%). Polyps were found in 39.4% and 38.5 %, respectively (P=0.91). At diagnosis, polyps were found more frequently in older (P=0.09), diabetic (P=0.007) patients, with higher number of systemic complications (P=0.004). Prevalence of polyps at diagnosis was significantly higher in patients with presumed disease onset greater than 5 years (median, P=0.013). Patients with IGF-I (P=0.003) and fasting glucose (FG, P=0.01) above the median showed significantly higher prevalence of polyps than those below. In patients who underwent colonoscopy after the diagnosis, age at diagnosis of acromegaly (P=0.03), FG (P<0.001), HbA1c (P=0.001), HOMAIR (P=0.05), and number of systemic complications (P=0.02) were significantly higher in patients with polyps than those with a normal colonoscopy. Overall among diabetic patients, polyps prevalence was significantly higher in patients administered with insulin than in those treated with oral antidiabetic drugs (35% vs 6.25%, P=0.04). Forty-nine patients (34.2%) underwent multiple evaluations with 10-years median of colonoscopy follow-up. Among patients with polyps at first colonoscopy, recurrence was present in 41.6% at the second evaluation, particularly in patients with uncontrolled acromegaly (P=0.06), glucose metabolism alterations (P=0.002), metabolic syndrome (MS, P=0.04), and diabetes treated with insulin therapy (P=0.02). In patients treated with SRLs polyps recurrence was lower than those treated differently (29.4% vs 66.6%, P=0.07). 30.4% of patients with first negative colonoscopy had polyps at the second evaluation, particularly those with uncontrolled acromegaly (P=0.03), smoking habit (P=0.002) and MS (P=0.06). Overall, five patients (3.5%) had colon cancer, diagnosed in two cases at acromegaly diagnosis and in three during the follow-up, after a mean disease duration of 18 years. Colonic polyposis is a major concern in patients with acromegaly. Regular colonoscopy is mandatory in this population. Recurrence is more common in patients with uncontrolled acromegaly, glucose metabolism alterations, and MS, requiring frequent colonoscopy evaluations.