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Acta Neurochirurgica

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01-11-2021 | Obstructive Sleep Apnea Syndrome | Original Article - Pituitaries

Prevalence and outcome of comorbidities associated with acromegaly

Authors: Sven Berkmann, Joël Brun, Philipp Schuetz, Emanuel Christ, Luigi Mariani, Beat Mueller

Published in: Acta Neurochirurgica | Issue 11/2021

Abstract

Background

Acromegaly is associated with various comorbidities, such as arterial hypertension (aHT), type 2 diabetes mellitus (DM2), obstructive sleep apnoea syndrome (OSAS), carpal tunnel syndrome (CTS) and polyposis coli. For therapeutic decisions, it is essential to know if, and to what extent, these associated morbidities are reversible or preventable. The aim of this study is to assess the prevalence and course of aHT, obesity, OSAS, CTS, DM2 and polyposis coli in acromegalic patients.

Methods

The following criteria for inclusion in this database study were used: treatment for acromegaly at the authors’ institutions; full endocrinological and radiological work- and follow-up; screening for aHT, DM2, CTS, OSAS, obesity and polyposis coli. All patients were followed-up for > 3 months, and treatments were indicated with the intent of biochemical remission (normal IGF-1 and random growth hormone level).

Results

Sixty-three patients were included. Twelve (19%), 45 (71%) and 6 (10%) patients harboured micro-, macro- and giant adenomas, respectively. Nineteen tumours (30%) invaded the cavernous sinus. Mean tumour volume was 5.4 cm³. Mean follow-up time was 42 months. Sixty-one (97%) patients had transsphenoidal surgery; two patients only had drug therapy. Surgery led to remission in 31 (51%) patients. Intracavernous growth and larger tumour volume were negative predictors for cure. Drug therapy lead to remission in 22 (73%) patients within a mean follow-up of 54 months. The pretherapeutic prevalence of associated morbidities was as follows: aHT, 56%; DM2, 25%; OSAS, 29%; CTS, 29%; polyposis coli, 5%. There were neither age nor gender preferences for the respective prevalences. Surgery leads to remission of aHT and DM2 in 6% and 25%, respectively. Additional drug therapy resulted in remission of aHT, DM2 and CTS in 17%, 14% and 14%, respectively. Other associated morbidities persisted regardless of therapeutic efforts. Even if criteria for remission were not met, no new comorbidities of acromegaly developed during follow-up.

Conclusions

Treating acromegaly may relieve threatening associated morbidities such as aHT and DM2; nevertheless, only few comorbidities are reversible, which highlights the importance of treating acromegaly as early as possible.

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Title: Prevalence and outcome of comorbidities associated with acromegaly
Authors: Sven Berkmann
Joël Brun
Philipp Schuetz
Emanuel Christ
Luigi Mariani
Beat Mueller
Publication date: 01-11-2021
Publisher: Springer Vienna
Keywords: Obstructive Sleep Apnea Syndrome
Carpal Tunnel Syndrome
Acromegaly
Carpal Tunnel Syndrome
Hypertension
Arterial Hypertension
Arterial Hypertension
Published in: Acta Neurochirurgica / Issue 11/2021
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-021-04846-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence and outcome of comorbidities associated with acromegaly

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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