Has acromegaly been diagnosed earlier?. (February 2018)

• Record Type: Journal Article
• Authors: Ohno, Hideko; Yoneoka, Yuichiro; Jinguji, Shinya; Watanabe, Naoto; Okada, Masayasu; Fujii, Yukihiko
• Is Part Of: Journal of clinical neuroscience. Volume 48(2018)
• Page Start: 138
• Page End: 142
• Publication Date: 2018-02
• Subjects: Acromegaly -- Early diagnosis -- IGF-1 -- Diabetes mellitus -- Hypertension; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2017.10.086
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Acromegaly has been diagnosed earlier at the author's institute in the past decade. The clinical features of acromegaly tend to be milder at diagnosis in recent years. GHomas were diagnosed with smaller size and lower IGF-1 levels in the latter half. Abstract: 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.