V Amodru1, P Petrossians2, A Colao3, B Delemer4, L Maione5, S J C M M Neggers6, B Decoudier4, P Kamenicky5, F Castinetti1, V Hana7, R Pivonello3, D Carvalho8, T Brue1, A Beckers2, P Chanson5, T Cuny9. 1. Aix Marseille Univ, APHM, INSERM, MMG, Service d'endocrinologie, Hôpital de la Conception, Marseille, France. 2. Department of Endocrinology, CHU de Liège, Université de Liege, Liège, Belgium. 3. Dipartimento Di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University "Federico II", Naples, Italy. 4. Service d'endocrinologie, CHU de Reims, Reims, France. 5. Service d'Endocrinologie et des Maladies de la Reproduction, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France. 6. Section of Endocrinology Department of Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. 7. Third Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. 8. Department of Endocrinology Diabetes and Metabolism, Centro Hospitalar Universitário S. João, Faculty of Medicine, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. 9. Aix Marseille Univ, APHM, INSERM, MMG, Service d'endocrinologie, Hôpital de la Conception, Marseille, France. thomas.cuny@ap-hm.fr.
Abstract
PURPOSE: Acromegaly is a rare disease due to growth hormone (GH)-secreting pituitary adenoma. GH and IGF-1 levels are usually congruent, indicating either remission or active disease; however, a discrepancy between GH and IGF-1 may occur. We aimed to evaluate the outcome of diabetes mellitus (DM) and hypertension (HT) in acromegalic patients with congruent GH and/or IGF-1 levels vs. discordant biochemical parameters. METHODS: Retrospective analysis of the data of 3173 patients from the Liege Acromegaly Survey (LAS) allowed us to include 190 patients from 8 tertiary referral centers across Europe, treated by surgery, with available data concerning DM and HT both at diagnosis and at the last follow-up (LFU). We recorded the number of anti-HT and anti-DM drugs used at the first evaluation and at LFU for every patient. RESULTS: Ninety-nine patients belonged to the REM group (concordant parameters), 65 patients were considered as GHdis (high random GH/controlled IGF-1), and 26 patients were considered as IGF-1dis (high IGF-1/controlled random GH). At diagnosis, 72 patients (37.8%) had HT and 54 patients had DM (28.4%). There was no statistically significant difference in terms of the number of anti-HT and anti-DM drugs at diagnosis versus LFU (mean duration: 7.3 ± 4.5 years) between all three groups. CONCLUSION: The long-term outcome of DM and HT in acromegaly does not tend to be more severe in patients with biochemical discordance in comparison with patients considered as in remission on the basis of concordant biological parameters, suggesting that patients with biochemical discordance do not require a closer follow-up.
PURPOSE:Acromegaly is a rare disease due to growth hormone (GH)-secreting pituitary adenoma. GH and IGF-1 levels are usually congruent, indicating either remission or active disease; however, a discrepancy between GH and IGF-1 may occur. We aimed to evaluate the outcome of diabetes mellitus (DM) and hypertension (HT) in acromegalicpatients with congruent GH and/or IGF-1 levels vs. discordant biochemical parameters. METHODS: Retrospective analysis of the data of 3173 patients from the Liege Acromegaly Survey (LAS) allowed us to include 190 patients from 8 tertiary referral centers across Europe, treated by surgery, with available data concerning DM and HT both at diagnosis and at the last follow-up (LFU). We recorded the number of anti-HT and anti-DM drugs used at the first evaluation and at LFU for every patient. RESULTS: Ninety-nine patients belonged to the REM group (concordant parameters), 65 patients were considered as GHdis (high random GH/controlled IGF-1), and 26 patients were considered as IGF-1dis (high IGF-1/controlled random GH). At diagnosis, 72 patients (37.8%) had HT and 54 patients had DM (28.4%). There was no statistically significant difference in terms of the number of anti-HT and anti-DM drugs at diagnosis versus LFU (mean duration: 7.3 ± 4.5 years) between all three groups. CONCLUSION: The long-term outcome of DM and HT in acromegaly does not tend to be more severe in patients with biochemical discordance in comparison with patients considered as in remission on the basis of concordant biological parameters, suggesting that patients with biochemical discordance do not require a closer follow-up.