Body mass index and metabolic complications in individuals with treatment-naïve acromegaly

Body mass index (BMI) can be used to define obesity-a global health concern and a risk factor for various complications. However, it does not accurately represent body composition. Furthermore, a correlation between BMI and the frequency of comorbidities in patients with acromegaly, a condition that affects body composition, remains unclear. This study aimed to investigate the association between BMI and frequency of metabolic complications in patients with acromegaly. This single-center, retrospective, cross-sectional study included patients with untreated acromegaly. The patients were divided into two groups: BMI <25 kg/m² and BMI ≥25 kg/m², and the prevalence of metabolic complications was compared between the groups. Of the 66 patients, the BMI <25 kg/m² group included 39 patients (BMI: 22.7 [20.0-24.1], insulin-like growth factor-1 [IGF-1] standard deviation score [SDS]: 6.7 [4.7-7.9]), and the BMI ≥25 kg/m² group included 27 patients (BMI: 27.6 [25.9-29.8], IGF-1 [SDS]: 8.5 [6.0-10.2]). The prevalence of metabolic complications did not differ between the groups, except for a lower incidence of fatty liver in the BMI <25 kg/m² group (8% vs. 29%, p = 0.04). In these patients, BMI was positively correlated with serum IGF-1 levels (r = 0.29, p = 0.01). Our results suggest that BMI is not useful in predicting metabolic complications in individuals with acromegaly, except for fatty liver disease.