Discordant biological parameters of remission in acromegaly do not increase the risk of hypertension or diabetes: a stud
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ORIGINAL ARTICLE
Discordant biological parameters of remission in acromegaly do not increase the risk of hypertension or diabetes: a study with the Liege Acromegaly Survey database 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. Cuny1 ●
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Received: 23 March 2020 / Accepted: 8 June 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Acromegaly GH IGF-1 Discordance Hypertension Diabetes ●
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Introduction Acromegaly is a rare disease generally due to a growth hormone (GH)-secreting pituitary adenoma [1]. Because the
* T. Cuny [email protected] 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
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Dipartimento Di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University “Federico II”, Naples, Italy
4
Service d’endocrinologie, CHU de Reims, Reims, France
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diagnosis is usually delayed by 5–10 years, the occurrence, progression, and aggravation of comorbidities related to the excess of GH are likely to occur [2].
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Service d’Endocrinologie et des Maladies de la Reproduction, Hôpital de
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