Frequency of acromegaly in adults with diabetes or glucose intolerance and estimated prevalence in the general population

Rosário, Pedro Weslley

doi:10.1007/s11102-010-0281-0

Cited by 64 publications

(45 citation statements)

References 35 publications

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“…The most common type of clinically significant PAs is prolactinsecreting (40% of all PAs), followed by nonfunctioning PAs (NFPAs) (37%) and growth hormone (GH)-secreting (somatotroph) adenomas (13%) (6). It was formerly thought that PA-caused acromegaly had a prevalence of 40-60 (7, 8) patients per million people, but more recent findings show that clinically relevant somatotroph adenomas present a rate of 124/1 000 000 (9) people in Europe and 480/1 000 000 (10) in Brazil. More than 70% of GH-secreting adenomas are larger than 10 mm in diameter (macroadenomas) at the time of diagnosis (11), probably because tumor formation can start as many as 10 years before diagnosis (7).…”

Section: Introductionmentioning

confidence: 99%

Polymorphisms in MEN1 and DRD2 genes are associated with the occurrence and characteristics of pituitary adenomas

Pečulis

Balcere

Rovīte

et al. 2016

European Journal of Endocrinology

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Objective: Although pituitary adenomas (PAs) affect a significant proportion of the population, only a fraction have the potential to become clinically relevant during an individual's lifetime, causing hormonal imbalance or complications due to mass effect. The overwhelming majority of cases are sporadic and without a clear familial history, and the genotype-phenotype correlation in PA patients is poorly understood. Our aim was to investigate the involvement of genes known for their role in familial cases on drug response and tumor suppression in the development and pathology of PAs in a patient group from Latvia. Design: The study included 143 cases and 354 controls, we investigated the role of single-nucleotide polymorphisms (SNPs) in seven genes (SSTR2, SSTR5, DRD2, MEN1, AIP, GNAS, and PRKAR1A) associated with pituitary tumor occurrence, phenotype, and clinical symptoms. Methods: Genotyping of 96 tag and nonsynonymous SNPs was performed in the genomic regions of interest. Results: We discovered a significant association (OR = 17.8, CI 0.95 = 2.18-145.5, P = 0.0002) between a rare MEN1 mutation (rs2959656) and clinically active adenoma in our patients. Additionally, rs7131056 at DRD2 was associated with a higher occurrence of extrasellar growth in patients with prolactinoma and somatotropinoma (OR = 2.79, CI 0.95 = 1.58-4.95, P = 0.0004). Conclusions: rs2959656, a nonsynonymous variant in MEN1, is associated with the development of clinically active PA. Furthermore, rs7131056 in DRD2 contributes to either faster growth of the adenoma or reduced symptomatic presentation, allowing PAs to become larger before detection.

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Section: Introductionmentioning

confidence: 99%

Polymorphisms in MEN1 and DRD2 genes are associated with the occurrence and characteristics of pituitary adenomas

Pečulis

Balcere

Rovīte

et al. 2016

European Journal of Endocrinology

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“…A cromegaly generally has an insidious onset and its prevalence may be underestimated (1)(2)(3). If untreated, the hypersecretion of growth hormone (GH) is associated with clinical complications and increased mortality (4,5).…”

Section: Introductionmentioning

confidence: 99%

Screening for acromegaly in adult patients not reporting enlargement of the extremities, but with arterial hypertension associated with another comorbidity of the disease

Rosário

Calsolari

2014

Arq Bras Endocrinol Metab

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Objective To determine the value of acromegaly screening in adult patients not reporting enlargement of the extremities, but who present arterial hypertension associated with at least one other comorbidity of the disease. Subjects and methods Patients seen by general practitioners at primary health care units were evaluated. Among the patients without extremity enlargement, those with recently diagnosed arterial hypertension associated with at least one other comorbidity were selected. Results A total of 1,209 patients were submitted to laboratory investigation. Elevated IGF‐1 was observed in 22 patients. Eighteen patients had adequate suppression of growth hormone (GH). No GH suppression was observed in four women with confirmed elevated IGF‐1. In the latter, IGF‐1 and nadir GH were only slightly elevated, magnetic resonance showed a normal pituitary, and chest and abdominal computed tomography revealed no tumor, and no intervention was performed. Conclusion In patients with arterial hypertension without known pituitary disease, acromegaly is unlikely in the absence of enlargement of the extremities.

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“…First, 4,350 adults (age between 18 and 70 years, excluding pregnant women and patients with known pituitary disease) underwent acromegaly screening: 2,270 patients with type 2 diabetes mellitus or glucose intolerance (19), 178 patients who reported "enlargement of their extremities" (20), and 1,902 patients with two or more comorbidities related to acromegaly [including arterial hypertension in 1,806 patients (21)]. In patients with elevated IGF-1, a new measurement was obtained and was combined with the measurement of GH during an OGTT.…”

Section: Patientsmentioning

confidence: 99%

Long-term follow-up of patients with elevated IGF-1 and nadir GH > 0.4 µg/L but < 1 µg/L

Rosário

Calsolari

2017

Arch. Endocrinol. Metab.

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Objective: To report the results of initial investigation and after 5 years of patients with a suspicious clinical scenario for acromegaly, elevated IGF-1, and nadir GH during an oral glucose tolerance test (OGTT) > 0.4 µg/L but < 1 µg/L. Subjects and methods: Seventeen patients who had elevated IGF-1 (outside puberty and pregnancy) in two measurements and GH between 0.4 and 1 µg/L during OGTT were selected. Results: During initial assessment, only one patient had microadenoma on magnetic resonance imaging (MRI) of the pituitary. In this patient, IGF-1 returned to normal spontaneously after 5 years. In the remaining 16 patients, spontaneous normalization of IGF-1 was observed in four and IGF-1 continued to be elevated in 12 after 5 years. None of the latter patients developed a phenotype of acromegaly, changes in physiognomy or increase in IGF-1 and no tumor was detected by imaging methods. Two patients had nadir GH < 0.4 µg/L, while the nadir GH remained between 0.4 and 1 µg/L in 10 patients. Conclusion: In patients (notably young adult or adult women) without a typical phenotype in whom IGF-1 is measured due to a suspicious clinical scenario and is found to be slightly elevated, even if confirmed and in the absence of other causes, a nadir GH cut-off value of 0.4 µg/L instead of 1 µg/L in the OGTT might be inadequate for the diagnosis. Arch Endocrinol Metab. 2017;61(5):426-31

show abstract

Frequency of acromegaly in adults with diabetes or glucose intolerance and estimated prevalence in the general population

Cited by 64 publications

References 35 publications

Polymorphisms in MEN1 and DRD2 genes are associated with the occurrence and characteristics of pituitary adenomas

Polymorphisms in MEN1 and DRD2 genes are associated with the occurrence and characteristics of pituitary adenomas

Screening for acromegaly in adult patients not reporting enlargement of the extremities, but with arterial hypertension associated with another comorbidity of the disease

Long-term follow-up of patients with elevated IGF-1 and nadir GH > 0.4 µg/L but < 1 µg/L

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