Endocrine Abstracts

Background and aim: Acromegaly is a rare condition caused by an excessive secretion of growth hormone (GH) and insulin-like growth factor1 (IGF-1), which are responsible for exaggerated somatic growth and cardiometabolic disturbances. This study aims to determine the prevalence of obesity in patients with acromegaly

Patients and Methods : We conducted a retrospective study (1997-2020) at the Endocrinology department of Hedi Chaker University Hospital, Sfax, Tunisia. We involved 30 patients diagnosed with acromegaly, whose clinical, biochemical, and imaging peculiarities were collected from medical charts.

Results : The mean age of diagnosis was 45.8±12.4 years with a male predominance (51.7%). The mean duration of symptoms was 5.1±5.4 years. Acromegaly was due to a somatotropic adenoma in 96.7%. An exceptional case of ectopic secretion of GHRH by a pancreatic neuroendocrine tumor was reported. The average weight was 82.5±13 Kg (extremes: 62-120 Kg). The average BMI was 28±7.2 Kg/m²(extremes: 17.5-40.5 Kg/m²). The BMI was normal in 18.6% of patients while 40.7% were overweight. We report an increased prevalence of obesity of 40.7%. The mean waist circumference was 97.7 cm (range 75-129 cm) in men and 100.3 cm (range 85-129 cm) in women. An android distribution of fat was found in 11 patients (5 men, 6 women), a prevalence of 36.6%.

Discussion: GH and IGF-1 are counterregulatory hormones that antagonize the metabolic effects of insulin in the liver and adipose tissue, creating a state of insulin resistance and altering fat distribution in acromegalic patients. Adipose tissue hyperplasia-hypertrophy, related to GH/IGF-1 excess, would aggravate the risk of obesity in this population. These adipose disturbances can regress in 10% of cases after surgical treatment.