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Has acromegaly been diagnosed earlier?

Hideko Ohno1, Yuichiro Yoneoka2, Shinya Jinguji3

  • 1Department of Neurosurgery, Brain Research Institute, Niigata University, Japan; Department of Neurosurgery, Tachikawa Medical Center, Yuyu-Kenko-Mura Hospital, Japan.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|November 9, 2017
PubMed
Summary

Acromegaly diagnosis has shifted towards earlier detection of milder cases with smaller pituitary tumors and lower IGF-1 levels over a decade. This trend suggests improved diagnostic capabilities for growth hormone-producing pituitary adenomas.

Keywords:
AcromegalyDiabetes mellitusEarly diagnosisHypertensionIGF-1

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Acromegaly, a disorder caused by excess growth hormone (GH), can lead to significant health complications.
  • Early diagnosis and treatment are crucial for managing acromegaly and preventing long-term consequences.
  • Pituitary adenomas are the most common cause of acromegaly.

Purpose of the Study:

  • To investigate trends in acromegaly diagnosis at Niigata Medical and Dental University Hospital.
  • To determine if acromegaly is being diagnosed earlier and with less severe clinical manifestations.
  • To compare patient characteristics and biochemical markers between early and late diagnostic periods.

Main Methods:

  • Retrospective review of 81 patients with acromegaly who underwent transsphenoidal surgery between 2006 and 2015.
  • Patients were divided into two groups: 2006-2010 (early) and 2011-2015 (late).
  • Comparison of clinical features, including tumor size, and serum levels of GH and IGF-1, as well as prevalence of hypertension and diabetes mellitus.

Main Results:

  • The late diagnosis group showed a higher prevalence of microadenomas (<10 mm) compared to the early group (15.2% vs. 0%).
  • Serum IGF-1 standard deviation score (SDS) was significantly lower in the late group (6.44 ± 2.30) than in the early group (8.57 ± 2.50).
  • Patients with diabetes mellitus had significantly higher GH and IGF-1 levels than those without.

Conclusions:

  • Acromegaly patients diagnosed in later years presented with milder clinical manifestations, smaller lesions, and lower IGF-1 levels.
  • The findings suggest a potential shift towards earlier diagnosis of GH-producing pituitary adenomas.
  • Further research is needed to confirm and generalize these observed trends in acromegaly diagnosis.