Endocrine Abstracts

Introduction: Acromegaly is a rare endocrine disease characterised by excess GH produced by a pituitary adenoma. It is associated with several complications and comorbidities. Metabolic alterations such as diabetes and dyslipidemia are quite frequent described in these patients.

Materials and methods: This is a retrospective observational cross-sectional study meant to assess the metabolic modifications in a group of acromegaly patients evaluated in our department.

Results: We included 67 patients in our study (38 female and 29 male). The mean age at diagnosis was 46.15 while mean disease duration was 10.42 years with 38 patients having below 10 years of disease activity. 77.6% of our patients presented with macroadenoma at diagnosis. There were 15 patients who refused surgery or had contraindication and 31 patients who did not undergo any type of radiotherapy. 42 patients received treatment at one point in time with a somatostatin analogue, 13 patients with pegvisomant and 26 patients with dopamine agonist. Out of all patients, 20 had no tumoral rest, no medical treatment and no disease activity (random GH<1 ng/ml, GH OGTT<0.4 ng/ml or GH/24 h<1 ng/ml, IGF1 < 1.3× upper superior limit adjusted for sex and age), 24 were in biochemical remission and 23 still had active disease with partial response. Diabetes was diagnosed in 42 patients (22 female and 20 male) and dyslipidemia in 52 patients (30 female and 22 male). People with more than 10 years of disease activity had higher IGF1/USL in female patients, higher glycemia in male patients and higher triglycerides with lower HDL cholesterol irrespective of sex. Diabetic patients had higher mean value for GH over 24 h and IGF1/USL compared to those without diabetes, irrespective of sex and irrespective of disease status (complete, biochemical or partial response). Female patients with dyslipidemia had higher mean value for GH over 24 h and IGF1/USL. Female patients presented higher IGF1/USL than men in both diabetic and dyslipidemic groups. In both diabetic and dyslipidemic groups, higher values of GH/24 h and IGF1/USL were correlated with higher glycemia (P>0.05) and triglycerides (P<0.05).

Conclusions: Acromegaly is a complex pathology and needs to be treated accordingly. Diabetes and dyslipidemia are important complications which do not need to be overlooked and could be linked to disease activity.

Keywords: acromegaly, diabetes, dyslipidemia, retrospective study