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Danilowicz K, Sosa S. Acromegaly and Cancer: An Update. Arch Med Res 2023; 54:102914. [PMID: 38007382 DOI: 10.1016/j.arcmed.2023.102914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/03/2023] [Accepted: 11/07/2023] [Indexed: 11/27/2023]
Abstract
Acromegaly is a chronic and rare disease. The diagnosis usually takes several years. Multiple comorbidities are associated with acromegaly. Long-term exposure to growth factors may lead to complications such as the development of benign or malignant tumors. However, the association between acromegaly and cancer remains a matter of debate due to multiple limitations in epidemiological data. There is controversy between acromegaly and mortality, but evidence shows a significant improvement in mortality rates with disease control and careful management of comorbidities. Older age, increased growth hormone levels (GH) at last follow-up, higher insulin-like growth factor-1 (IGF-1) levels at diagnosis, malignancy and radiotherapy were proposed as independent predictors of mortality. In this review we summarize the current state of knowledge in this field. Incidence of different cancer types is described. Rigorous surveillance of endocrine diseases may contribute to increased tumor detection. Personalized screening should probably be recommended.
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Affiliation(s)
- Karina Danilowicz
- Division of Endocrinology, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Soledad Sosa
- Division of Endocrinology, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina
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Oguz SH, Firlatan B, Sendur SN, Dagdelen S, Erbas T. Follow, consider, and catch: second primary tumors in acromegaly patients. Endocrine 2023; 80:160-173. [PMID: 36517649 DOI: 10.1007/s12020-022-03282-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIM The risk of second primary tumors is increased in general cancer population, however, there is no data on acromegalic cancer patients in this regard. The aim of this study is to determine the prevalence of patients with two primary tumors among acromegalic cancer patients and to evaluate if patients with two primaries have distinct clinical characteristics or risk factors compared to those with one. METHODS This is a single-center retrospective cohort study. The study included 63 patients with at least one malignant tumor out of a total number of 394 acromegaly patients. Patients with multiple primary neoplasms were evaluated in detail. RESULTS This study revealed a 16% cancer prevalence in acromegaly patients, with 14% (9/63) having two primary neoplasms. Papillary thyroid carcinoma was the most prevalent tumor in the entire cancer cohort (41%, 26/63), and in the group of patients with two primaries (44%, 4/9). Patients with two primary tumors were older than those with one when diagnosed with acromegaly (48.3 ± 16.6 vs. 43.3 ± 10.7 years), which might be attributed to a longer diagnostic delay (median of 4.5 vs. 2 years). The period between the onset of acromegaly symptoms and diagnosis was not associated with earlier cancer diagnosis. No relationship between circulating GH or IGF-I levels and the number of neoplasms was found. CONCLUSION The development of second primary tumors in acromegalic patients with cancer diagnosis is not rare. Acromegalic cancer patients should be closely monitored for new symptoms or signs that could be associated with second primary tumors.
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Affiliation(s)
- Seda Hanife Oguz
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Busra Firlatan
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Suleyman Nahit Sendur
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
| | - Selcuk Dagdelen
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tomris Erbas
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
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Vargas-Ortega G, Romero-Gameros CA, Rendón-Macias ME, Balcázar-Hernández L, Sosa-Eroza E, Mercado M, de Los Monteros-Sánchez ALE, Pérez-Aguilar B, Paredes-Manjarrez C, Reyes-Olhagaray FB, Serrano-Ramírez DL, la Cruz EVMD, González-Virla B. Risk factors associated with thyroid nodular disease in acromegalic patients: A case-cohort study in a tertiary center. Growth Horm IGF Res 2021; 60-61:101431. [PMID: 34740022 DOI: 10.1016/j.ghir.2021.101431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/24/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Goiter is very common in patients with acromegaly; its development is correlated to the duration of the disease. Thyroid cells express the IGF-1 receptor and the TSH/IGF-1 interaction has been demonstrated to have a synergistic effect in thyroid cell growth. There is a correlation between IGF-1 levels and the thyroid volume of patients with acromegaly. The aim of this study was to evaluate, in a retrospective case-cohort study of patients with acromegaly, the associated risk factors for thyroid nodules disease in this population. METHODS This was a case-cohort study matched by age, gender, and growth hormone at diagnosis. Cases consisted of acromegalic patients that developed thyroid nodules during the follow up, and controls consisted in acromegalic patients without thyroid nodules. A Cox proportional hazard estimation was carried out for measure the associated risk factors for thyroid nodules disease in acromegalic patients. A nodular thyroid disease-free survival analysis was estimated using the Kaplan-Meier analysis. RESULTS We recruited 49 cases and 56 controls. In a multivariate Cox proportional hazard analysis age and IGF-1 ≥ 2.2 x ULN were significantly related with the presence of thyroid nodules [HR of 2.21 (95% CI; 1.15-4.25, p = 0.01)]. Nodularity-free survival rates in patients who had an IGF-1 X ULN ≥ 2.2 was found to be lower in comparison to those who had IGF-1 X ULN < 2.2, according to a Kaplan-Meier survival analysis. CONCLUSIONS Our findings support that exist more probability to develop thyroid nodular disease in patients with acromegaly that present IGF-1 X ULN ≥ 2.2, suggesting a possible direct effect between the time of exposure to the IGF-1 axis hyperactivity and the genesis of thyroid nodules.
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Affiliation(s)
- Guadalupe Vargas-Ortega
- Endocrinology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Carlos Alfonso Romero-Gameros
- Otorhinolaryngology Head and Neck Surgery Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Lourdes Balcázar-Hernández
- Endocrinology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Ernesto Sosa-Eroza
- Endocrinology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Moises Mercado
- Medical Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Barbara Pérez-Aguilar
- Endocrinology Service, Hospital General de Mexico, Secretaria de Salud, Mexico City, Mexico
| | - Carlos Paredes-Manjarrez
- Radiology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Fernando Bernardo Reyes-Olhagaray
- Radiology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Diana Laura Serrano-Ramírez
- Endocrinology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Erick Vladimir Martínez-De la Cruz
- Endocrinology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Baldomero González-Virla
- Endocrinology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
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Topaloglu O, Evren B, Uzun M, Yologlu S, Guldogan E, Sahin I. Is there a Relationship between Serum IGF-1 and Thyroid Nodule, Thyroid or Ovarian Volume in Polycystic Ovarian Syndrome? ACTA ENDOCRINOLOGICA-BUCHAREST 2021; 17:138-146. [PMID: 34539923 DOI: 10.4183/aeb.2021.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Context Studies investigating the association between serum IGF-1, and thyroid nodule, ovarian or thyroid volume in polycystic ovarian syndrome (PCOS) are limited. Objective We aimed to analyze the association between serum IGF-1 level, and ovarian or thyroid volume, or thyroid nodule in PCOS. Design The study was performed between June 2017 and August 2019 as prospective design. Subjects and Methods Adult females with new-onset PCOS were included. The patients having comorbid illness, or using medication were excluded. Basic tests, thyroid and ovarian sonography were performed. The patients were grouped according to thyroid nodule(absent/present) and ovarian volume (<10mL/≥10mL). We planned to find a positive association between IGF-1, and thyroid nodule, thyroid or ovarian volume in PCOS. Results Of total 118 patients, 11(9%) had thyroid nodule. The patients with thyroid nodule had a higher ovarian volume (p=0.006). No correlation was found between GH or IGF-1, and thyroid or ovarian volume. IGF-1 was not a predictor for thyroid nodule or higher ovarian volume. Thyroid nodule was a significant predictor for higher ovarian volume. Conclusion Our study is the first to analyze the association between IGF-1 and thyroid nodule in PCOS. We found that thyroid nodule was associated with thyroid and ovarian volume, but IGF-1 was not associated with thyroid nodule, thyroid or ovarian volume.
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Affiliation(s)
- O Topaloglu
- Kocaeli Derince Training and Research Hospital - Endocrinology, Kocaeli, Inonu University School of Medicine
| | | | - M Uzun
- University of Health Sciences, Izmir Suat Seren Chest Diseases and Surgery Training and Research Hospital - Intensive Care Unit, Izmir, Turkey
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Danilowicz K, Sosa S, Gonzalez Pernas MS, Bamberger E, Diez SM, Fainstein-Day P, Furioso A, Glerean M, Guitelman M, Katz D, Lemaitre N, Lowenstein A, Del Valle Luna M, Martínez MP, Miragaya K, Moncet D, Ortuño MV, Pignatta A, Ramacciotti CF, Reyes A, Rogozinski AS, Slavinsky P, Tkatch J, Pitoia F. Acromegaly and thyroid cancer: analysis of evolution in a series of patients. Clin Diabetes Endocrinol 2020; 6:24. [PMID: 33292786 PMCID: PMC7672811 DOI: 10.1186/s40842-020-00113-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/02/2020] [Indexed: 01/07/2023] Open
Abstract
Background Acromegaly is associated with higher morbidity and mortality mainly due to cardiovascular disease. Data on the incidence and evolution of thyroid cancer in acromegaly are controversial. Our objective was to describe the characteristics of a group of acromegalic patients with differentiated thyroid carcinoma (DTC) and analyze their evolution. Methods This is a retrospective multicenter study of 24 acromegalic patients with DTC. The AJCC Staging System 8th Edition was used for TNM staging, and the initial risk of recurrence (RR), initial response and response at the end of follow-up (RFU) were defined according to the 2015 ATA Guidelines. As a control group, 92 patients with DTC without acromegaly were randomly included. Statistical analyses were done using SPSS Statistics 20.0. Results Median age of patients at diagnosis of acromegaly was 49.5 years (range 12–69). The median delay in diagnosis of acromegaly was 3 years (range 0.5–23). Mean baseline IGF-1 level was 2.9 ± 1.1 ULN. Median age at DTC diagnosis was 51.5 years (18–69). At the moment of diagnosis of DTC, 58.3% of the patients had active acromegaly. Median time from DTC diagnosis to acromegaly control was 1.25 years (0.5–7). Mean DTC tumor diameter of the biggest lesion was 14.6 ± 9.2 mm, being multifocal in 37.5%. All tumors were papillary carcinomas, two cases being of an aggressive variety. Lymph node dissection was performed in 8 out of 24 patients and 62.5% had metastases. Only one patient had distant metastases. Radioiodine ablation was given to 87.5% of patients. Nineteen patients (79%) were stage I, four (17%) stage II and one (4%) stage IVb. Initial RR was low in 87% (21/24), intermediate in 9% (2/24) and high in 4% (1/24) patient. RFU was: 83% (19/23) patients with no evidence of disease, 9% (2/23) with indeterminate response, 4% (1/23) with biochemical incomplete response and 4% (1/23) with structural incomplete response, at a median time of FU of 36.5 months. When comparing RFU between acromegalics and controls no statistically significant differences were found. Conclusions Patients with acromegaly and DTC mostly had a low initial RR. When compared with the control group, we found that DTC patients with acromegaly did not have a worse evolution. Supplementary Information The online version contains supplementary material available at 10.1186/s40842-020-00113-4.
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Affiliation(s)
- Karina Danilowicz
- Endocrinology Division, Hospital de Clínicas José de San Martín- Universidad de Buenos Aires, Buenos Aires, Argentina. .,Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.
| | - Soledad Sosa
- Endocrinology Division, Hospital de Clínicas José de San Martín- Universidad de Buenos Aires, Buenos Aires, Argentina.,Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina
| | - Mariana Soledad Gonzalez Pernas
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Endocrinology Division, FLENI, Buenos Aires, Argentina
| | - Elizabeth Bamberger
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Centro Privado de Endocrinología, Mendoza, Argentina
| | - Sabrina Mara Diez
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Endocrinology Division, Hospital Pirovano, Buenos Aires, Argentina
| | - Patricia Fainstein-Day
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Department of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Alejandra Furioso
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Endocrinology Division, Hospital Ramos Mejía, Buenos Aires, Argentina
| | - Mariela Glerean
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Department of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Mirtha Guitelman
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Endocrinology Division, Hospital Carlos G. Durand, Buenos Aires, Argentina
| | - Débora Katz
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Endocrinology Division, FLENI, Buenos Aires, Argentina
| | - Nicole Lemaitre
- Endocrinology Division, Hospital Ángel C. Padilla, Tucumán, Argentina
| | - Alicia Lowenstein
- Endocrinology Division, Hospital Ramos Mejía, Buenos Aires, Argentina
| | | | | | - Karina Miragaya
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Endocrinology Division, Sanatorio Güemes, Buenos Aires, Argentina
| | - Daniel Moncet
- Endocrinology Division, Hospital Privado de Comunidad, Mar del Plata, Buenos Aires, Argentina
| | | | - Analía Pignatta
- Endocrinology Division, Hospital Interzonal San Juan Bautista, San Fernando del Valle de Catamarca, Catamarca, Argentina
| | | | - Adriana Reyes
- Endocrinology Division, Hospital Ramos Mejía, Buenos Aires, Argentina
| | - Amelia Susana Rogozinski
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Endocrinology Division, Hospital Ramos Mejía, Buenos Aires, Argentina
| | - Patricia Slavinsky
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Endocrinology Division, FLENI, Buenos Aires, Argentina
| | - Julieta Tkatch
- Neuroendocrine Department, Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires, Argentina.,Endocrinology Division, Hospital Carlos G. Durand, Buenos Aires, Argentina
| | - Fabián Pitoia
- Endocrinology Division, Hospital de Clínicas José de San Martín- Universidad de Buenos Aires, Buenos Aires, Argentina
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YILMAZ N, TAZEGÜL G, SARI R, ALTUNBAŞ H, BALCI M. Akromegali hastalarında benign ve malign tümör sıklığı. PAMUKKALE MEDICAL JOURNAL 2020. [DOI: 10.31362/patd.656681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
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Parolin M, Dassie F, Vettor R, Maffei P. Acromegaly and ultrasound: how, when and why? J Endocrinol Invest 2020; 43:279-287. [PMID: 31502218 DOI: 10.1007/s40618-019-01111-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/03/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Acromegaly is a rare disease caused by an excess of growth hormone and insulin-like growth factor 1. It is usually diagnosed because of typical signs such as macroglossia, acral enlargement, jaw prognathism and malocclusion. Systemic complications are a major cause of morbidity and mortality in acromegaly, and many patients remain undiagnosed for several years. Increased ultrasound (US) application in the general population, and including among acromegaly patients, has revealed many suggestive features which, taken together with clinical suspicion, could induce suspicion of this disease. PURPOSE This review describes main US features in acromegaly. Echocardiography shows a typical cardiomyopathy, characterized by left ventricular hypertrophy, diastolic and systolic dysfunction, aortic and mitral regurgitation, and increased aortic root diameters. US preclinical markers of atherosclerosis, such as intima media thickness (IMT), seem also to be impaired. Visceromegaly and increased organ stiffness are other features of acromegaly, including enlarged prostate, kidneys, liver, and thyroid. In addition, other US findings are: renal cysts, micronephrolithiasis, impairment of renal haemodynamic parameters, gallstones and gallbladder polyps, hepatic steatosis, thyroid nodules, multinodular goiter, and polycystic ovaries. Musculoskeletal US findings are increased cartilage thickness, impaired density and elasticity of bones, nerve enlargement, carpal and cubital tunnel syndrome, and trigger finger. CONCLUSIONS Acromegaly patients frequently present systemic complications and a diagnostic delay. US features of acromegaly are not specific, but could potentially have a key role in early detection of the disease in the presence of typical clinical features.
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Affiliation(s)
- M Parolin
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy.
| | - F Dassie
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy
| | - R Vettor
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy
| | - P Maffei
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy
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Takamizawa T, Horiguchi K, Nakajima Y, Okamura T, Ishida E, Matsumoto S, Yoshino S, Yamada E, Saitoh T, Ozawa A, Tosaka M, Yamada S, Yamada M. Central Hypothyroidism Related to Pituitary Adenomas: Low Incidence of Central Hypothyroidism in Patients With Acromegaly. J Clin Endocrinol Metab 2019; 104:4879-4888. [PMID: 31188431 DOI: 10.1210/jc.2019-00466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/06/2019] [Indexed: 12/15/2022]
Abstract
CONTEXT The most frequent cause of central hypothyroidism (CeH) is pituitary adenomas, but the mechanisms remain unclear. OBJECTIVE We investigated serum thyroid levels and GH/IGF-1 in central hypothyroidism in untreated patients with pituitary nonfunctioning and GH-secreting adenomas. DESIGN This was a retrospective cross-sectional study of cases collected from Gunma University and Toranomon Hospitals between 2007 and 2016. PATIENTS One-hundred thirty-nine cases of nonfunctioning pituitary adenoma (NFPA) and 150 cases of GH-secreting pituitary adenoma (GHPA) were analyzed. MAIN OUTCOME MEASURES The correlations between thyroid levels, several clinicopathological parameters, and GH/IGF-1 were examined. RESULTS Twenty-four percent of NFPA patients had CeH. The severity did not correlate with tumor size, age, or sex, and all cases had normal TSH levels. In contrast, only 8.7% of GHPA patients had CeH; approximately half had normal TSH levels and approximately half had low TSH levels. Serum TSH levels in GHPA patients were significantly lower and free T4 (FT4) and free T3 levels were higher than those in patients with NFPA. Furthermore, approximately one-fourth of GHPA patients had normal FT4 and low TSH levels. In addition, serum FT4 levels and serum TSH levels were positively and negatively correlated, respectively, with serum IGF-1 levels. Furthermore, IGF-1 levels in patients with GHPA decreased with age. CONCLUSIONS (i) NFPA patients with CeH had TSH levels within a normal range. (ii) GHPA patients had a low incidence of CeH, which may be a result of stimulated thyroid function by GH/IGF-1. (iii) We found an age-dependent decrease in serum IGF-1 levels in patients with GHPA.
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Affiliation(s)
- Tetsuya Takamizawa
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kazuhiko Horiguchi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yasuyo Nakajima
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takashi Okamura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Emi Ishida
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Shunichi Matsumoto
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Satoshi Yoshino
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Eijiro Yamada
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tsugumichi Saitoh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Atsushi Ozawa
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masahiko Tosaka
- Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Shozo Yamada
- Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Minato-ku, Tokyo, Japan
- Hypothalamic Pituitary Center, Tokyo Neurologic Center Hospital, Nishikasai, Tokyo, Japan
| | - Masanobu Yamada
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
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Kan S, Kizilgul M, Celik B, Beysel S, Caliskan M, Apaydin M, Ucan B, Cakal E. The effect of disease activity on thyroid nodules in patients with acromegaly. Endocr J 2019; 66:301-307. [PMID: 30745501 DOI: 10.1507/endocrj.ej18-0502] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Nodular thyroid disease is a very common disorder in patients with acromegaly. Insulin-like growth factor-1 (IGF-1) is a thyroid growth factor, and there is a correlation between IGF-1 levels and thyroid volume (TV) in patients with acromegaly. There is no study investigating the impact of somatostatin analog (SSA) treatment on thyroid nodule volume in patients with acromegaly. We aimed to assess thyroid nodule volume change with SSA treatment in patients with persistent acromegaly. We retrospectively analyzed data from 108 consecutive patients with acromegaly who were followed up by our clinic after undergoing surgery between 2002 and 2014. Patients who were cured after surgery were excluded. We only selected 43 patients (21 males, 22 females, mean age 52.8 ± 11.9 years) who did not meet the criteria of remission postoperatively, who were treated with SSA for at least six months and had normal thyroid function. Patients were divided into three groups (well-controlled, controlled, and active) according to their IGF-1 and growth hormone (GH) levels. All patients underwent an evaluation of TV and total thyroid nodule volume (TTNV) by ultrasound. TTNV decreased significantly in patients with well-controlled acromegaly (0.44 [0.75] to 0.23 [0.73], p < 0.001). TTNV did not change in controlled patients (0.18 [1.28] to 0.13 [1.54], p = 0.959); however TTNV increased in patients with active acromegaly (0.77 [1.46] to 1.03 [1.88], p = 0.028). Successful medical treatment of patients with active acromegaly decreases thyroid nodule volume. Sustained exposure to IGF-1 may cause an increase in thyroid nodule volume in patients with acromegaly.
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Affiliation(s)
- Seyfullah Kan
- Department of Endocrinology and Metabolism, Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Muhammed Kizilgul
- Department of Endocrinology and Metabolism, Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Bulent Celik
- Department of Statistics, Gazi University, Faculty of Science, Ankara, Turkey
| | - Selvihan Beysel
- Department of Endocrinology and Metabolism, Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Mustafa Caliskan
- Department of Endocrinology and Metabolism, Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Mahmut Apaydin
- Department of Endocrinology and Metabolism, Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Bekir Ucan
- Department of Endocrinology and Metabolism, Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, Diskapi Teaching and Research Hospital, Ankara, Turkey
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