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DECREASE IN ACROMEGALY-ASSOCIATED THYROID ENLARGEMENT AFTER NORMALIZATION OF IGF-1 LEVELS: A PROSPECTIVE OBSERVATION

Zhiyong Chen, Xiaobing Jiang, Yajuan Feng

    Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
    |December 21, 2019
    PubMed
    Summary
    This summary is machine-generated.

    Normalizing insulin-like growth factor 1 (IGF-1) in acromegaly patients significantly reduced thyroid volume. IGF-1 promotes thyroid cell growth and function, highlighting its role in acromegaly-related goiter.

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    Area of Science:

    • Endocrinology
    • Oncology
    • Cell Biology

    Background:

    • Goiter is common in acromegaly patients, but the impact of normalized insulin-like growth factor 1 (IGF-1) on thyroid volume is unclear.
    • Acromegaly patients exhibit significantly larger thyroid volumes compared to controls.
    • The duration of acromegaly is independently linked to thyroid volume enlargement.

    Purpose of the Study:

    • To investigate whether normalizing IGF-1 levels in acromegaly patients can reduce goiter and thyroid volume.
    • To evaluate the in vitro effects of IGF-1 on thyroid cell proliferation, cell cycle, and apoptosis.

    Main Methods:

    • Compared thyroid volume and hormone levels in 101 acromegaly patients, 108 with nonfunctioning pituitary adenoma (NFPA), and 55 healthy controls.
    • Assessed changes in thyroid volume and hormone levels in 34 acromegaly patients one year post-surgery.
    • Utilized in vitro assays to determine IGF-1's impact on thyroid cell proliferation, cell cycle, and apoptosis.

    Main Results:

    • Acromegaly patients had significantly larger thyroid volumes (18.32 mL) than NFPA patients (9.91 mL) and healthy controls (9.63 mL).
    • In surgically cured acromegaly patients, median thyroid volume decreased (22.74 to 17.87 mL; P = .003), correlating with IGF-1 levels (r = 0.37; P = .029).
    • In vitro studies showed IGF-1 dose- and time-dependently increased thyroid cell proliferation and secretory function while inhibiting apoptosis.

    Conclusions:

    • Thyroid volume increase associated with acromegaly is reversible upon successful treatment and IGF-1 normalization.
    • IGF-1 directly promotes thyroid cell proliferation and function, contributing to goiter development in acromegaly.
    • Nodular goiter prevalence did not significantly change post-treatment, suggesting other contributing factors.