4.3 Article

Has acromegaly been diagnosed earlier?

Journal

JOURNAL OF CLINICAL NEUROSCIENCE
Volume 48, Issue -, Pages 138-142

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2017.10.086

Keywords

Acromegaly; Early diagnosis; IGF-1; Diabetes mellitus; Hypertension

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Purpose: We investigated whether acromegaly has been diagnosed earlier at the Niigata Medical and Dental University Hospital. Methods: Patients with acromegaly (n = 81) who underwent their first transsphenoidal surgery from 2006 to 2015 were reviewed. Two groups were compared: those who underwent surgery between 2006 and 2010 (n = 35) and those who underwent surgery between 2011 and 2015 (n = 46). We compared clinical features and serum levels of the growth hormone (GH) and insulin-like growth factor-1 (IGF-1), hypertension (HT) and diabetes mellitus (DM) prevalence between the two groups. Results: Compared with the early group, microadenomas (<10 mm) were more prevalent in the late group (0% vs. 15.2%, p < .05). Serum IGF-1 standard deviation score (SDS) was significantly lower in the late group (8.57 +/- 2.50 vs. 6.44 +/- 2.30, p < .001). In both groups, mean IGF-1 SDS was significantly lower in patients without DM than in those with DM (6.9 +/- 2.6 vs. 8.3 +/- 2.4, p = .02). Logistic regression analysis showed that serum GH and IGF-1 levels were significantly higher in patients with DM than in those without DM. Conclusion: Regarding operated cases of GH-producing pituitary adenoma, acromegaly clinical manifestations tended to be milder at diagnosis in later years of the decade, and acromegaly was diagnosed at lower IGF-1 levels and in smaller lesions. Further study is mandatory for the generalization of this trend. (C) 2017 The Authors. Published by Elsevier Ltd.

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