Prostatic hyperplasia: an unknown feature of acromegaly

Area of Science:

• Endocrinology
• Urology

Background:

• Excess growth hormone (GH) and insulin-like growth factor I (IGF-I) are characteristic of acromegaly.
• The potential link between GH/IGF-I excess and prostate diseases, including benign prostatic hyperplasia and prostatic carcinoma, requires investigation.

Purpose of the Study:

• To investigate the relationship between GH and IGF-I excess and the development of prostate diseases.
• To assess prostate dimensions, volume, and disease occurrence in acromegalic patients compared to healthy controls.

Main Methods:

• Ultrasonography was used to measure prostatic diameters and volume in 10 untreated acromegalic patients (<40 years) and 10 matched healthy controls.
• Hormone levels (GH, IGF-I, testosterone, etc.) were assessed before and after 1 year of octreotide treatment in acromegalics.
• Hyperprolactinemic patients received additional cabergoline treatment.

Main Results:

• Acromegalics exhibited significantly increased prostatic diameter and volume compared to controls.
• The prevalence of periurethral calcifications was higher in acromegalics (50%) than controls (20%).
• Octreotide treatment normalized GH/IGF-I in 7/10 patients, leading to a significant reduction in prostate volume and diameters, while testosterone levels increased.

Conclusions:

• Prostate enlargement and calcifications are prevalent in young acromegalic males.
• Normalization of GH and IGF-I levels through treatment can reduce prostate size.
• Prostate screening is recommended for acromegalic males during work-up and follow-up.