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Michalski ADC, Ferreira ADS, Kasuki L, Gadelha MR, Lopes AJ, Guimarães FS. Clinical and functional variables can predict general fatigue in patients with acromegaly: an explanatory model approach. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:235-240. [PMID: 31038594 PMCID: PMC10522193 DOI: 10.20945/2359-3997000000127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 01/14/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate whether hormonal profile, arterial function, and physical capacity are predictors of fatigue in patients with acromegaly. Subjects and methods: This is a cross-sectional study including 23 patients. The subjects underwent a Modified Fatigue Impact Scale (MFIS) assessment; serum growth hormones (GH) and IGF-1 measurements; pulse wave analysis comprising pulse wave velocity (PWV), arterial compliance (AC), and the reflection index (IR1,2); dominant upper limb dynamometry (DYN); and the six-minute walking distance test (6MWT). Multiple linear regression models were used to identify predictors for MFIS. The coefficient of determination R2 was used to assess the quality of the models' fit. The best model was further analyzed using a calibration plot and a limits of agreement (LOA) plot. RESULTS The mean ± SD values for the participants' age, MFIS, PWV, AC, IR1,2, DYN, and the distance in the 6MWT were 49.4 ± 11.2 years, 31.2 ± 18.9 score, 10.19 ± 2.34 m/s, 1.08 ± 0.46 x106 cm5/din, 85.3 ± 29.7%, 33.9 ± 9.3 kgf, and 603.0 ± 106.1 m, respectively. The best predictive model (R2 = 0.378, R2 adjusted = 0.280, standard error = 16.1, and P = 0.026) comprised the following regression equation: MFIS = 48.85 - (7.913 × IGF-I) + (1.483 × AC) - (23.281 × DYN). CONCLUSION Hormonal, vascular, and functional variables can predict general fatigue in patients with acromegaly.
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Affiliation(s)
- André da Cunha Michalski
- Centro Universitário Augusto MottaPrograma de Pós-Graduação em Ciências da ReabilitaçãoCentro Universitário Augusto MottaRio de JaneiroRJBrasilPrograma de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
| | - Arthur de Sá Ferreira
- Centro Universitário Augusto MottaPrograma de Pós-Graduação em Ciências da ReabilitaçãoCentro Universitário Augusto MottaRio de JaneiroRJBrasilPrograma de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
| | - Leandro Kasuki
- Universidade Federal do Rio de JaneiroFaculdade de MedicinaHospital Universitário Clementino Fraga FilhoUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Centro de Pesquisa em Neuroendocrinologia, Serviço de Endocrinologia, Faculdade de Medicina, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Instituto Estadual do Cérebro Paulo NiemeyerSecretaria Estadual de Saúde do Rio de JaneiroRio de JaneiroRJBrasil Divisão de Neuroendocrinologia, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Monica R. Gadelha
- Universidade Federal do Rio de JaneiroFaculdade de MedicinaHospital Universitário Clementino Fraga FilhoUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Centro de Pesquisa em Neuroendocrinologia, Serviço de Endocrinologia, Faculdade de Medicina, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Instituto Estadual do Cérebro Paulo NiemeyerSecretaria Estadual de Saúde do Rio de JaneiroRio de JaneiroRJBrasil Divisão de Neuroendocrinologia, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Agnaldo José Lopes
- Centro Universitário Augusto MottaPrograma de Pós-Graduação em Ciências da ReabilitaçãoCentro Universitário Augusto MottaRio de JaneiroRJBrasilPrograma de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
| | - Fernando Silva Guimarães
- Centro Universitário Augusto MottaPrograma de Pós-Graduação em Ciências da ReabilitaçãoCentro Universitário Augusto MottaRio de JaneiroRJBrasilPrograma de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de JaneiroDepartamento de FisioterapiaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Fisioterapia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
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Guedes da Silva DP, Guimarães FS, Dias CM, Guimarães SDA, Kasuki L, Gadelha MR, Camilo GB, Lopes AJ. On the functional capacity and quality of life of patients with acromegaly: are they candidates for rehabilitation programs? J Phys Ther Sci 2013; 25:1497-501. [PMID: 24396219 PMCID: PMC3881486 DOI: 10.1589/jpts.25.1497] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 06/24/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study compared patients having active acromegaly with those having
controlled acromegaly in terms of peripheral muscle strength, body composition, and
functional capacity. We also examined the associations between these measures. [Methods] A
total of 14 patients with active acromegaly, 12 patients with controlled acromegaly, and
12 healthy controls were subjected to isometric dynamometry, surface electromyography,
electrical bioimpedance, and a six-minute walk test. [Results] The active acromegaly group
exhibited significantly more fat-free mass than the control group. With respect to the
peripheral muscle performance, the controlled acromegaly group presented a significantly
lower electromyographic median frequency than the control group. The quadriceps maximum
strength was significantly lower in the controlled acromegaly group than in the control
group. The fat-free mass was significantly correlated with the quadriceps maximum
strength. The global scores of the Acromegaly Quality of Life Questionnaire were
significantly correlated with the six-minute walk distance. [Conclusion] Patients with
acromegaly have more fat-free mass, less peripheral muscle strength, and greater
fatigability than healthy control subjects. These findings depend on the degree of
hormonal control. In acromegalic patients, peripheral muscle strength is related to body
composition, and functional capacity is correlated with quality of life.
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Affiliation(s)
| | | | - Cristina Márcia Dias
- Rehabilitation Sciences Master's Program, Augusto Motta University Center, Brazil
| | | | - Leandro Kasuki
- Department of Endocrinology, Federal University of Rio de Janeiro, Brazil
| | | | | | - Agnaldo José Lopes
- Rehabilitation Sciences Master's Program, Augusto Motta University Center, Brazil
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Urinary calcium excretion and insulin resistance in patients with acromegaly. Int Urol Nephrol 2012; 44:1473-7. [PMID: 22234795 DOI: 10.1007/s11255-011-0116-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 12/22/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Renal complications in acromegaly include glomerular hyperfiltration, insulin resistance, hypercalciuria and urolithiasis. The aim of this study was to investigate whether urinary calcium (U(Ca)) excretion is a direct consequence of growth hormone secretion or secondary to hyperfiltration and/or insulin resistance. METHODS We performed a cross-sectional study of 58 patients diagnosed with acromegaly. Demographic data were obtained, serum analysis was performed, including insulin-like growth factor (IGF)-1, and 24-h urine collection, to measure urinary protein excretion, U(Ca) and phosphate excretion, as well as fractional excretion of sodium and potassium. We also calculated the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS Patients were predominantly male (60.3%), and their mean age was 45.9 ± 14 years. Hypercalciuria was present in 24% of patients. Patients with higher HOMA-IR had higher IGF-1 levels, a trend toward higher body mass index and higher U(Ca) excretion. In univariate analysis, U(Ca) excretion was associated with HOMA-IR (r = 0.472, P = 0.001), phosphaturia (r = 0.457, P = 0.001), IGF-1 (r = 0.398, P = 0.002) and creatinine clearance (r = 0.394, P = 0.001). HOMA-IR and phosphaturia were independently associated with U(Ca) excretion. No independent associations were found between phosphaturia and HOMA-IR or IGF-1. CONCLUSIONS The present study revealed an association between hypercalciuria and insulin resistance in patients with acromegaly. Further studies are required to fully understand the pathogenesis of these abnormalities in patients with acromegaly.
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Rosario PW. Frequency of acromegaly in adults with diabetes or glucose intolerance and estimated prevalence in the general population. Pituitary 2011; 14:217-21. [PMID: 21170595 DOI: 10.1007/s11102-010-0281-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to evaluate the frequency of acromegaly in adults with diabetes mellitus (DM) or glucose intolerance (GI) and to estimate its prevalence in the general population. A total of 2,270 patients with DM or GI and age from 20 to 70 years were studied. Patients with known pituitary disease and pregnant women were excluded. Serum IGF-1 was measured in all subjects and, if elevated, a new measurement was obtained together with the measurement of GH in the oral glucose tolerance test (OGTT). Patients with persistently elevated IGF-1 and inadequate suppression of GH were submitted to magnetic resonance imaging (MRI). Acromegaly was not suspected by the assistant physician in any of the patients. Six patients had persistently elevated IGF-1 and inadequate suppression of GH in the OGTT (without other conditions associated with GH or IGF-1 elevation). Pituitary adenoma was detected by MRI in three patients, and two subjects presented an acromegalic phenotype. Two patients were submitted to transsphenoidal surgery, with immunohistochemistry confirming immunoreactivity for GH. Another patient was treated with octreotide LAR which resulted in the normalization of IGF-1 and GH. Considering a prevalence of DM or GI of 20% in adults and the occurrence of these co-morbidities in 55% of patients with acromegaly, the frequency of 3/2,270 found in this study permits to estimate 480 cases/1,000,000 adults. The present results suggest that the prevalence of acromegaly is underestimated and further studies are needed to evaluate the cost-effectiveness of biochemical screening in certain groups of patients.
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Affiliation(s)
- Pedro Weslley Rosario
- Postgraduation Program, Santa Casa de Belo Horizonte, Av Francisco Sales, 1111, 9ºD, Santa Efigênia, CEP 30150-221, Belo Horizonte, MG, Brazil.
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Rosario PW. Normal values of serum IGF-1 in adults: results from a Brazilian population. ACTA ACUST UNITED AC 2011; 54:477-81. [PMID: 20694409 DOI: 10.1590/s0004-27302010000500008] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 05/04/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine the normal values of serum IGF-1 (Immulite 2000) in a Brazilian adult (21-70 years) population. SUBJECTS AND METHODS Healthy volunteers were divided into 10 groups according to age (5-year intervals), with 100 subjects (50 men and 50 women) per group. One-hundred participants were selected for repetition of the test after 12 weeks. RESULTS No difference in IGF-1 values was observed between men and women, but a progressive reduction of serum IGF-1 with age was seen. The reference values provided by the manufacturer of the assay, although discretely higher, were very close to the values found in this study. A second measurement of IGF-1 after 12 weeks revealed a variation < 20% in 99% of subjects. CONCLUSIONS This study established the reference range for IGF-1 determined with the Immulite 2000 assay for a large number of healthy Brazilian adults stratified according to age, and suggests that variations > 20% in IGF-1 levels within an interval of 12 weeks cannot be attributed to interassay variability.
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Affiliation(s)
- Pedro Weslley Rosario
- Santa Casa de Belo Horizonte, Departamento de Neuroendocrinologia, Santa Casa de Belo Horizonte, MG, Brazil.
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Vieira Neto L, Abucham J, Araujo LAD, Boguszewski CL, Bronstein MD, Czepielewski M, Jallad RS, Musolino NRDC, Naves LA, Ribeiro-Oliveira Júnior A, Vilar L, Faria MDS, Gadelha MR. Recomendações do Departamento de Neuroendocrinologia da Sociedade Brasileira de Endocrinologia e Metabologia para o diagnóstico e tratamento da acromegalia no Brasil. ACTA ACUST UNITED AC 2011; 55:91-105. [DOI: 10.1590/s0004-27302011000200001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 02/06/2011] [Indexed: 12/27/2022]
Abstract
A acromegalia é uma doença associada à elevada morbidade e à redução da expectativa de vida. Em virtude do seu caráter insidioso e do seu não reconhecimento, o diagnóstico é frequentemente realizado com atraso, o que, associado às complicações relacionadas ao excesso do GH/IGF-I, determina elevada morbimortalidade. No entanto, um diagnóstico precoce e um tratamento efetivo minimizam a morbidade e normalizam a taxa de mortalidade. Nesta publicação, o objetivo do Departamento de Neuroendocrinologia da Sociedade Brasileira de Endocrinologia e Metabologia é divulgar quando suspeitar clinicamente da acromegalia e como diagnosticá-la. Além disso, discute-se a maneira mais eficaz e segura de realizar o tratamento da acromegalia, enfatizando que este deve ser realizado em centros de referência. Assim, com base em dados publicados em periódicos de nível científico reconhecido e na experiência dos autores, são apresentadas as recomendações para o diagnóstico e tratamento da doença.
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Affiliation(s)
- Leonardo Vieira Neto
- Hospital Universitário Clementino Fraga Filho, Brasil; Hospital da Lagoa, Brasil
| | | | | | | | | | | | | | | | | | | | | | | | - Mônica R. Gadelha
- Hospital Universitário Clementino Fraga Filho, Brasil; Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Brasil
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Correa LL, Taboada GF, Van Haute FR, Casini AF, Balarini GA, Vieira Neto L, Machado EDO, Fontes R, Andrade CCD, Schrank Y, Gadelha MR. [Evaluation of glucose metabolism in acromegalic patients before and after treatment with octreotide LAR]. ACTA ACUST UNITED AC 2009; 52:55-64. [PMID: 18345397 DOI: 10.1590/s0004-27302008000100009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Accepted: 10/30/2007] [Indexed: 11/21/2022]
Abstract
AIM OF THE STUDY To evaluate the glucose metabolism in acromegalic patients before and after treatment with octreotide LAR. PATIENTS AND METHODS This was a prospective and longitudinal study involving 30 patients from the acromegaly research outpatient clinic of the Endocrinology unit of the HUCFF/UFRJ. They underwent clinical and laboratorial evaluations, with measurements of growth hormone (GH), insulin-like growth factor type I (IGF-I), insulin, proinsulin, C peptide, glycosylated hemoglobin (HbA1c), IGF binding protein type 1 (IGFBP-1) and glucose, during oral glucose tolerance test (OGTT), before and after six months of treatment with octreotide LAR. The Wilcoxon signed-rank test was used and values of 5% were considered statistically significant. RESULTS We found 16 (54%) patients with normal glucose tolerance, 7 (23%) with impaired glucose tolerance and 7 (23%) diabetics. Twelve patients completed the six-month treatment, out of which three showed worsening of glucose tolerance and two (diabetics) had worse blood glucose control. Whereas there was an increase in waist circumference (p=0.03), there was a decrease in GH (p=0.04), with %IGF-I above the upper limit of reference values (% ULRV) [p=0.001], insulin (p=0.019), C peptide levels (p=0.002) and homeostatic model assessment (HOMA-IR) [p=0.039]. CONCLUSIONS In this series, treatment with octreotide LAR led to a worsening of glucose tolerance in three non-diabetic patients and worsened glycemic control in two diabetics, in spite of reducing insulin resistance.
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Affiliation(s)
- Lívia L Correa
- Serviço de Endocrinologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, RJ, Brazil
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8
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van Haute FRB, Taboada GF, Corrêa LL, Lima GAB, Fontes R, Riello AP, Dominici M, Gadelha MR. Prevalence of sleep apnea and metabolic abnormalities in patients with acromegaly and analysis of cephalometric parameters by magnetic resonance imaging. Eur J Endocrinol 2008; 158:459-65. [PMID: 18362291 DOI: 10.1530/eje-07-0753] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To determine the prevalence of sleep apnea (SA) and SA syndrome (SAS) in patients with acromegaly and correlate SA with clinical, laboratory, and cephalometric parameters. DESIGN AND METHODS Prospective and cross-sectional study of 24 patients with active acromegaly evaluated by clinical and laboratory (GH, IGF-I) parameters, polysomnography and magnetic resonance imaging (MRI) of the pharynx. RESULTS Out of 24 patients, 21 had SA (87.5%), of which 20 (95.3%) had the predominant obstructive type. Median age of these 21 patients was 54 years (range 23-75) and median estimated disease duration was 60 months (range 24-300). The frequency in SA patients of impaired glucose tolerance, diabetes mellitus (DM), and hypertension was 19, 33.3, and 71.4% respectively. Goiter was found in 10 patients (47.6%) and obesity in 18 (90%). Median GH level was 14 mug/l (1.4-198) and median %IGF-I (percentage above the upper limit of normal range of IGF-I) was 181% (-31.6 to 571.2). The prevalence of SAS was 52.4%. Apnea-hypopnea index (AHI) correlated significantly with age, waist circumference, body mass index, and hypopharynx area. The AHI was significantly higher in patients with hypertension and DM. CONCLUSIONS The prevalence of SA and SAS in acromegaly was similar to the one previously described in other series. Age was a significant risk factor, and hypertension and DM were significantly associated complications of SA. Obesity was also significantly related to SA, as a risk factor, a complication or both. Overall, cephalometric parameters by MRI did not correlate with SA.
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Affiliation(s)
- Flávia R B van Haute
- Hospital Universitário Clementino Fraga Filho, Serviço de Endocrinologia, Universidade Federal do Rio de Janeiro, 21941-913 Rio de Janeiro, Brazil
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Cavalin LR, Oliveira MLD, Diehl LA. Octreotide-LAR-associated erythema multiforme in an acromegalic subject: case report. ARQUIVOS BRASILEIROS DE ENDOCRINOLOGIA E METABOLOGIA 2008; 52:138-40. [PMID: 18345409 DOI: 10.1590/s0004-27302008000100021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Accepted: 03/08/2007] [Indexed: 11/21/2022]
Abstract
Long-acting somatostatin analogs are often used for treating acromegaly, either as adjuvant to surgery or radiotherapy or, more recently, as a primary therapeutic option. These drugs seem to be reasonably safe, but new adverse effects not yet described may occur during the use of the relatively new long-acting formulations. In this case report, we describe a severe cutaneous reaction (erythema multiforme) in a patient treated with long-acting release (LAR) octreotide, and also discuss the need of previous "testing" with short subcutaneous preparation of octreotide.
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Affiliation(s)
- Leda R Cavalin
- Department of Clinical Medicine, Universidade Estadual de Londrina, Brazil.
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Gonçalves FT, Feibelmann TCM, Fernandes MLMP, Fonseca ARC, Arantes HP, Jorge PT. [Discrepancy between IGF-1 and GH during 75 g oral glucose tolerance test measures to acromegaly screening in a patient with macroprolactinoma--case report and literature review]. ARQUIVOS BRASILEIROS DE ENDOCRINOLOGIA E METABOLOGIA 2007; 51:494-9. [PMID: 17546251 DOI: 10.1590/s0004-27302007000300020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Accepted: 09/22/2006] [Indexed: 05/15/2023]
Abstract
We describe a patient with macroprolactinoma and discrepant insulin-like growth factor (IGF-1) concentration (elevated) and growth hormone (GH) values during a 75 g oral glucose tolerance test (normal), that were measured to evaluate the co-secretion of GH by tumor. With the bromocriptin use, the patient achieved normalization of prolactin, but persisted with high levels of IGF1, suggesting to be subclinical acromegaly. After the development of new more sensitive GH assays, cases of discrepant GH and IGF-1 results have been observed and taken to some authors to suggest that GH nadir concentration during 75 g OGTT used to acromegaly diagnosis and treatment could be lower than values considered currently normal. Thus, if this is confirmed, subclinical and oligosymptomatic acromegaly cases could have earlier diagnoses.
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Casini AF, Araújo PB, Fontes R, Xavier SS, Gadelha MR. [Cardiac morphology and performance alterations and analysis of determinant factors of left ventricular hypertrophy in 40 patients with acromegaly]. ACTA ACUST UNITED AC 2006; 50:82-90. [PMID: 16628279 DOI: 10.1590/s0004-27302006000100012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Acromegaly has a high mortality rate due mainly to cardiovascular complications. The aim was to evaluate the determinant factors of left ventricular hypertrophy (LVH) and cardiac alterations in 40 acromegalic patients submitted to clinical-laboratorial studies and echocardiogram. The variables analyzed were age, sex, disease duration, arterial hypertension (AH), impaired glucose tolerance/DM, previous treatment with octreotide, GH and %IGF-I. Univaried analysis showed that patients with LVH were older (p= 0.031), had higher prevalence of AH (p= 0.009) and higher %IGF-I (p= 0.002), than those without LVH. Multivaried analysis showed AH and %IGF-I as determinants of LVH (p= 0.035 and p= 0.016). After dichotomizing of %IGF-I, a score was created and the frequency of LVH was 9%, 65%, 92% x 0, 1, 2; p< 0.0001. Prevalence of aortic ectasia was higher and valvar disease was smaller than reported in the literature. We conclude that AH and %IGF-I were determinants of LVH.
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Affiliation(s)
- Alessandra Ferri Casini
- Serviço de Endocrinologia, Hospital Universitário Clementino Fraga Filho, UFRJ, Rio de Janeiro, RJ
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Taboada GF, van Haute FR, Corrêa LL, Casini AF, Gadelha MR. Etiologic aspects and management of acromegaly. ACTA ACUST UNITED AC 2005; 49:626-40. [PMID: 16444346 DOI: 10.1590/s0004-27302005000500004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Acromegaly is a systemic disease with various etiologies. It can occur as a sporadic or, more rarely, as a familial disease. Numerous complications such as endocrine, cardiovascular, respiratory, metabolic, osteoarticular and neoplastic disturbances occur and must be taken into account when establishing a therapeutic strategy. For this reason, the decision as to a treatment modality of acromegaly must be followed by a thorough evaluation of the patient and once the diagnosis of complications is settled, adequate treatment should be instituted. Follow up of the patients requires periodical re-assessment of complications’ status.
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Affiliation(s)
- Giselle F Taboada
- Endocrine Unit, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ
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