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Systemic complications of acromegaly: epidemiology, pathogenesis, and management

Annamaria Colao1, Diego Ferone, Paolo Marzullo

  • 1Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, 80131 Naples, Italy. colao@unina.it

Endocrine Reviews
|February 11, 2004
PubMed

Insights

Acromegaly significantly increases mortality due to cardiovascular and respiratory issues. Effective treatment of acromegaly improves these systemic complications, including heart problems and sleep apnea.

Area of Science:

  • Endocrinology
  • Internal Medicine
  • Cardiology

Background:

  • Acromegaly, a disorder caused by excess growth hormone (GH) and insulin-like growth factor-I (IGF-I), leads to significant systemic complications.
  • Cardiovascular and respiratory diseases are major contributors to increased mortality in acromegaly patients.

Purpose of the Study:

  • To review the systemic complications associated with acromegaly.
  • To discuss the impact of acromegaly on cardiovascular, respiratory, neoplastic, and musculoskeletal systems.
  • To evaluate the benefits of treatment on these complications.

Main Methods:

  • This is a review article synthesizing existing research on acromegaly complications.
  • Information was gathered from various investigations focusing on mortality, morbidity, and treatment outcomes.

Main Results:

  • Biventricular hypertrophy is the most common cardiac complication, independent of hypertension. Diastolic and systolic dysfunction, arrhythmias, and hypertension are prevalent.
  • Respiratory disorders, including sleep apnea, contribute to mortality but improve with GH/IGF-I control.
  • Increased risk of colonic polyps is noted, while arthropathy is a major cause of disability, potentially reversible in early stages.

Conclusions:

  • Acromegaly treatment, via surgery or pharmacotherapy (e.g., somatostatin analogs), effectively reduces cardiovascular and respiratory morbidity.
  • Controlling GH and IGF-I hypersecretion is crucial for managing systemic complications and improving patient outcomes.
  • Early intervention for arthropathy is recommended to prevent irreversible functional disability.

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