Complications and Comorbidities of Acromegaly—Retrospective Study in Polish Center

Abstract

IntroductionIn acromegaly, chronic exposure to impaired GH and IGF-I levels leads to the development of typical acromegaly symptoms, and multiple systemic complications as cardiovascular, metabolic, respiratory, endocrine, and bone disorders. Acromegaly comorbidities contribute to decreased life quality and premature mortality. The aim of our study was to assess the frequency of acromegaly complications and to evaluate diagnostic methods performed toward recognition of them.Materials and MethodsIt was a retrospective study and we analyzed data of 179 patients hospitalized in the Department of Endocrinology, Diabetes and Isotope Therapy in Wroclaw Medical University (Poland) in 1976 to 2018 to create a database for statistical analysis.ResultsThe study group comprised of 119 women (66%) and 60 men (34%). The median age of acromegaly diagnosis was 50.5 years old for women (age range 20–78) and 46 for men (range 24–76). Metabolic disorders (hyperlipidemia, diabetes, and prediabetes) were the most frequently diagnosed complications in our study, followed by cardiovascular diseases and endocrine disorders (goiter, pituitary insufficiency, osteoporosis). BP measurement, ECG, lipid profile, fasting glucose or OGTT were performed the most often, while colonoscopy and echocardiogram were the least frequent.ConclusionsIn our population we observed female predominance. We revealed a decrease in the number of patients with active acromegaly and an increase in the number of well-controlled patients. More than 50% of patients demonstrated a coexistence of cardiac, metabolic and endocrine disturbances and only 5% of patients did not suffer from any disease from those main groups.

Acromegaly: Clinical Care in Central and Eastern Europe, Israel, and Kazakhstan

“…The severity of these complications is correlated with diagnostic delay and the presence of active acromegaly (1). These include cardiovascular and metabolic complications (5,(12)(13)(14)(15), in addition to respiratory, intestinal, and skeletal disorders and particular neoplasms (5,14,(16)(17)(18)(19), all of which can impair patients' quality of life and may contribute to increased mortality (10). Women of reproductive age may also experience menstrual cycle disorders that coincide with the initial onset of acromegaly symptoms (20).…”

“…Women of reproductive age may also experience menstrual cycle disorders that coincide with the initial onset of acromegaly symptoms ( 20 ). Data from Bulgaria and Poland showed that 95% of patients suffered from comorbidities, with other endocrine and metabolic diseases and cardiovascular disease being the most common ( 12 , 21 ), co-occurring in 50% of patients ( 12 ). Of note, while the overall mortality in patients with acromegaly has decreased, the biochemical control of disease activity with normalized GH and IGF-I does not always correlate with clinical well-being ( 10 ).…”

Разходи За Лечение На Съпътстващи Заболявания При Пациенти С Акромегалия – Преглед На Литературата

“…Повече от 50% от пациентите с акромегалия имат сърдечно-съдови, метаболитни и ендокринни заболявания и само 5% от пациентите не страдат от друго заболяване [3]. Различни фактори предопределят тежестта и развитието на съпътстващи заболявания: нива на IGF-1, растежен хормон, възраст на пациента, продължителността на заболяването, размер на туморната маса, генетична предиспозиция и др.…”

Diabetic Ketoacidosis in Undiagnosed Acromegaly: A Case Report and Literature Review

“…11,12 Diabetes mellitus (DM) is a common complication of acromegaly, with a prevalence ranging from 19 -56%. 3,13 The primary mechanism of DM in acromegaly is growth hormone (GH)-induced insulin resistance, 14 thus hyperosmolar hyperglycemic state (HHS) would be expected as in Type 2 DM complications, instead of DKA. 15…”

“…Diabetic ketoacidosis (DKA) is both a potentially deadly hyperglycemic crisis and one of the most common causes of diabetes-related hospitalization in the U.S. 1 , 2 DKA currently is not established as a complication of acromegaly, 3 – 5 even though many authors have described their association. 6 , 7 This case reports a middle-aged male patient with a long history of untreated acromegaly who developed DKA.…”