The potential utility of the SAGIT instrument in the clinical assessment of patients with acromegaly, a large single-centre study

Abstract

SAGIT is an instrument created for the clinical assessment of acromegaly. Our objective was to test the usefulness of this tool in assessing disease activity of acromegalic patients in a single centre of Poznan, Poland using a retrospective study. Medical records of patients with acromegaly hospitalised at the Department of Endocrinology, Metabolism and Internal Medicine of Poznan University of Medical Sciences in Poland between January 2015 and December 2020 were analysed. SAGIT scores were assessed according to each patient's clinical and biochemical data. The results show that SAGIT scores were higher in treatment-naïve patients and the lowest in controlled patients. There were positive correlations between SAGIT scores and concentrations of calcium, phosphorus, HbA1C levels, and tumour invasiveness at the time of diagnosis. However, parameters such as age, vitamin D concentration, and time from diagnosis showed an inverse relationship with the SAGIT score. In ROC curve analysis, SAGIT scores of 5 or less discriminated controlled patients from uncontrolled (p < 0.0001, sensitivity 76.7%, specificity 78.5%, AUC 0.867). Also, SAGIT higher than 6 indicated for treatment start or escalation (p < 0.0001, sensitivity 80.88%, specificity 77.59%, AUC 0.866). Lack of signs and symptoms (S = 0) could not discriminate between controlled and uncontrolled disease, but predicted therapy maintenance (p < 0.0004, sensitivity 59.5%, specificity 58.2%, AUC 0.604). In conclusion, The SAGIT instrument is easy to use even when completed in the retrospective medical record review. It can be useful for distinguishing clinical stages of acromegaly and in decision-making.

Serum Phosphorus and Calcium as Biomarkers of Disease Status in Acromegaly

“…This finding is supported by the literature, where a statistically significant correlation between preoperative and postoperative levels and SAGIT scores has been established [2]. Our recent study on SAGIT's potential utility in the clinical assessment of patients with acromegaly revealed positive correlations between SAGIT scores and concentrations of Ca, P, HbA1C levels, and tumor invasiveness at the time of diagnosis [25]. However, parameters such as age, vitamin D concentration, and time from diagnosis showed an inverse relationship with the SAGIT score [25].…”

“…Our recent study on SAGIT's potential utility in the clinical assessment of patients with acromegaly revealed positive correlations between SAGIT scores and concentrations of Ca, P, HbA1C levels, and tumor invasiveness at the time of diagnosis [25]. However, parameters such as age, vitamin D concentration, and time from diagnosis showed an inverse relationship with the SAGIT score [25]. The correlation of serum P with IGF-1 levels helps to resolve a dispute between smaller studies that did not find significant correlation and supports findings by Xie et al and Piskinpasa et al [2,3,13].…”

“…Each of the above units was scored by a clinician: S(0-4), A(0-6), G(0-4), I(0-3), and T(0-5). The higher the score in each category and the total sum of points, the greater the advancement of a given factor and overall disease activity [5,14,25]. The Bioethical Committee of Poznan University of Medical Sciences approved this study and waived the requirement for informed consent given the study's retrospective nature (Decision No.…”