Pituitary diseases may cause psychiatric and personality alterations. We aimed to compare the personality traits of acromegalic patients with those of patients with non-functioning pituitary adenomas and a healthy control group.
Design
Fifty-eight acromegalic patients, 45 patients with non-functioning adenoma, and 40 healthy subjects were enrolled in the study. Cloninger's Temperament and Character Inventory (TCI), Beck Depression Inventory, Beck Anxiety Inventory, and Rosenberg Self-Esteem Scale (RSES) were used to assess personality, depression, anxiety, and self-esteem.
Results
Depression score was higher in acromegaly and non-functioning adenoma groups than healthy controls. RSES scores were similar among the three groups. Regarding the scales of TCI, only novelty-seeking was significantly reduced in acromegaly and non-functioning adenoma than the control group. Pairwise comparisons revealed that the difference was due to the difference between acromegalic patients and controls. Scales of TCI were correlated with depression and anxiety in patients with acromegaly and non-functioning adenoma but not in healthy controls.
Conclusion
This study showed that novelty-seeking was reduced in patients with acromegaly. Both the hormonal lack and excess and structural changes can lead to cognitive and personality changes in acromegaly. More studies are needed to be carried out about personality characteristics in pituitary diseases.
{"title":"Personality traits in acromegalic patients: Comparison with patients with non-functioning adenomas and healthy controls","authors":"Elif Kilic Kan , Aysegul Atmaca , Gokhan Sarisoy , Gulcin Cengiz Ecemis , Feyzi Gokosmanoglu","doi":"10.1016/j.ghir.2021.101439","DOIUrl":"10.1016/j.ghir.2021.101439","url":null,"abstract":"<div><h3>Objectives</h3><p>Pituitary diseases may cause psychiatric and personality alterations. We aimed to compare the personality traits of acromegalic patients with those of patients with non-functioning pituitary adenomas and a healthy control group.</p></div><div><h3>Design</h3><p><span>Fifty-eight acromegalic patients, 45 patients with non-functioning adenoma<span>, and 40 healthy subjects were enrolled in the study. Cloninger's Temperament and Character Inventory (TCI), Beck Depression Inventory, </span></span>Beck Anxiety Inventory, and Rosenberg Self-Esteem Scale (RSES) were used to assess personality, depression, anxiety, and self-esteem.</p></div><div><h3>Results</h3><p><span>Depression score was higher in acromegaly and non-functioning adenoma groups than healthy controls. RSES scores were similar among the three groups. Regarding the scales of TCI, only novelty-seeking was significantly reduced in acromegaly and non-functioning adenoma than the control group. Pairwise comparisons revealed that the difference was due to the difference between acromegalic patients and controls. Scales of TCI were correlated with depression and anxiety </span>in patients with acromegaly and non-functioning adenoma but not in healthy controls.</p></div><div><h3>Conclusion</h3><p>This study showed that novelty-seeking was reduced in patients with acromegaly. Both the hormonal lack and excess and structural changes can lead to cognitive and personality changes in acromegaly. More studies are needed to be carried out about personality characteristics in pituitary diseases.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"62 ","pages":"Article 101439"},"PeriodicalIF":1.4,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39651867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.1016/j.ghir.2021.101441
Lili Cao , Xiuying Chen , Lili Huang
Objective
An intrauterine device (IUD) is one of the most effective reversible contraceptive methods currently available. Women who use IUDs may become pregnant, albeit rarely, and many such women continue to use IUDs. Because it is difficult to remove or it may cause miscarriage. This study measured the changes in human leucocyte antigen-G (HLA-G) and insulin-like growth factor II (IGF-II) levels in the decidua and villi to explore the effect of a copper IUD on embryonic development.
Design
A total of 54 samples of decidual and villus tissue were collected from pregnant women with IUDs (27 samples) or without IUDs (27 samples). Hematoxylin-eosin staining was used to identify morphological characteristics. Immunohistochemistry was used to detect HLA-G and IGF-II; the protein expression levels were measured via Western blotting.
Results
HLA-G was expressed on the membranes of trophoblasts of villus tissues and the glandular epithelium, and in stromal cells of decidual tissues, in both the IUD and control groups. IGF-II was expressed in the glandular epithelium and cytoplasm of trophoblasts and decidual cells in both groups. Compared to the control group, IGF-II expression was significantly reduced in villus tissues of the IUD group (p < 0.05). The mean sac diameter was significantly positively correlated with IGF-II expression in the villi (p < 0.05).
Conclusions
A copper IUD may affect embryonic development by regulating the expression of villus IGF-II.
{"title":"Effect of a copper intrauterine device on HLA-G and IGF-II levels during pregnancy","authors":"Lili Cao , Xiuying Chen , Lili Huang","doi":"10.1016/j.ghir.2021.101441","DOIUrl":"10.1016/j.ghir.2021.101441","url":null,"abstract":"<div><h3>Objective</h3><p>An intrauterine device (IUD) is one of the most effective reversible contraceptive methods currently available. Women who use IUDs may become pregnant, albeit rarely, and many such women continue to use IUDs. Because it is difficult to remove or it may cause miscarriage. This study measured the changes in human leucocyte antigen-G (HLA-G) and insulin-like growth factor II (IGF-II) levels in the decidua and villi to explore the effect of a copper IUD on embryonic development.</p></div><div><h3>Design</h3><p>A total of 54 samples of decidual and villus tissue were collected from pregnant women with IUDs (27 samples) or without IUDs (27 samples). Hematoxylin-eosin staining was used to identify morphological characteristics. Immunohistochemistry was used to detect HLA-G and IGF-II; the protein expression levels were measured via Western blotting.</p></div><div><h3>Results</h3><p>HLA-G was expressed on the membranes of trophoblasts of villus tissues and the glandular epithelium, and in stromal cells of decidual tissues, in both the IUD and control groups. IGF-II was expressed in the glandular epithelium and cytoplasm of trophoblasts and decidual cells in both groups. Compared to the control group, IGF-II expression was significantly reduced in villus tissues of the IUD group (p < 0.05). The mean sac diameter was significantly positively correlated with IGF-II expression in the villi (<em>p</em> < 0.05).</p></div><div><h3>Conclusions</h3><p>A copper IUD may affect embryonic development by regulating the expression of villus IGF-II.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"62 ","pages":"Article 101441"},"PeriodicalIF":1.4,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1096637421000642/pdfft?md5=1e8c04839a2ab881e9049c5a50c93b00&pid=1-s2.0-S1096637421000642-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39679407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.1016/j.ghir.2021.101442
Maria Cristina Costa de Almeida , Claudia Maria Vilas Freire , Maria do Carmo P. Nunes , Beatriz Santana Soares , Marcia M. Barbosa , Alexandre Varella Giannetti , Giancarlo Pereira Zille , Paulo Augusto Carvalho Miranda , Antonio Ribeiro-Oliveira Jr , Juliana Beaudette Drummond
Objective
Cardiovascular (CV) disease is still a major cause of excessive morbidity and mortality in patients with active acromegaly, which may be attributed to a high prevalence of associated pro-atherosclerotic risk factors. However, a direct effect of GH/IGF-1 excess on the vasculature has been previously suggested, warranting further investigation. The present study was designed to investigate whether chronic GH/IGF-1 excess is associated with an increased prevalence of subclinical atherosclerosis in patients with acromegaly.
Design
We measured carotid intima-media thickness (cIMT) and assessed carotid plaques by ultrasonography along with classical CV risk factors in 54 acromegaly patients (34 females, 50 ± 12 years and compared those with 62 (42 females, 53 ± 13 years) age-, sex- and CV risk factors- matched controls. In order to compare cIMT measurements between patients and controls we analyzed common carotid artery far wall data as well as a combined measurement result, which consisted of the mean value of the six different measurements, three at each side.
Results
mean ± SD serum GH and IGF-1 levels were 2.76 ± 4.65 ng/mL and 1.7 ± 1.25 x ULN, respectively, in all acromegaly patients. Age, body mass index, blood pressure, lipid levels, fasting glucose and Framingham's global cardiovascular risk score classification were similar comparing patients and controls. Combined median [IQR] cIMT measurements were similar in acromegaly patients and matched controls (0.59 [0.52–0.66] mm vs. 0.59 [0.52–0.69] mm; P = 0.872) as well as in acromegaly patients with active and controlled disease (0.59 [0.51–0.68] mm vs. 0.60 [0.54–0.68] mm; P = 0.385). No significant correlations were observed between cIMT measurements and GH (Spearman r = 0.1, P = 0.49) or IGF-1 (Spearman r = 0.13, P = 0.37) levels in patients with acromegaly. Carotid atherosclerotic plaques prevalence was similar in patients and controls (26% vs. 32%; P = 0.54) as well as in patients with active and controlled acromegaly (22% vs. 30%; P = 0.537).
Conclusions
Our data suggest that GH/IGF-1 excess itself is not one of the main drivers of subclinical morphological atherosclerosis changes in patients with acromegaly and that optimal control of acromegaly-associated CV risk factors may preserve vasculature structure even when strict biochemical control is not achieved.
目的:心血管(CV)疾病仍然是活动性肢端肥大症患者高发病率和高死亡率的主要原因,这可能归因于相关的促动脉粥样硬化危险因素的高患病率。然而,GH/IGF-1过量对脉管系统的直接影响已经被提出,需要进一步的研究。本研究旨在探讨慢性GH/IGF-1过量是否与肢端肥大症患者亚临床动脉粥样硬化患病率增加有关。我们测量了54例肢端肥大症患者(34例女性,50±12岁)的颈动脉内膜-中膜厚度(cIMT),并通过超声检查评估了颈动脉斑块以及典型的心血管危险因素,并与62例(42例女性,53±13岁)年龄、性别和心血管危险因素匹配的对照组进行了比较。为了比较患者和对照组之间的cIMT测量结果,我们分析了颈总动脉远壁数据以及联合测量结果,该结果由六种不同测量值的平均值组成,每侧三种。结果所有肢端肥大症患者的平均±SD血清GH和IGF-1水平分别为2.76±4.65 ng/mL和1.7±1.25 x ULN。患者和对照组的年龄、体重指数、血压、血脂水平、空腹血糖和Framingham全球心血管风险评分分类相似。肢端肥大症患者和匹配对照组的中位cIMT测量值相似(0.59 [0.52-0.66]mm vs. 0.59 [0.52-0.69] mm;P = 0.872)以及活动性和控制疾病的肢端肥大症患者(0.59 [0.51-0.68]mm vs. 0.60 [0.54-0.68] mm;p = 0.385)。肢端肥大症患者的cIMT测量与GH (Spearman r = 0.1, P = 0.49)或IGF-1 (Spearman r = 0.13, P = 0.37)水平无显著相关性。患者和对照组的颈动脉粥样硬化斑块患病率相似(26% vs. 32%;P = 0.54)以及活动性和控制性肢端肥大症患者(22% vs. 30%;p = 0.537)。结论GH/IGF-1过量本身并不是肢端肥大症患者亚临床形态动脉粥样硬化改变的主要驱动因素之一,即使没有严格的生化控制,对肢端肥大相关的心血管危险因素的最佳控制也可能保留血管结构。
{"title":"“Subclinical atherosclerosis in acromegaly: Possible association with cardiovascular risk factors rather than disease activity”","authors":"Maria Cristina Costa de Almeida , Claudia Maria Vilas Freire , Maria do Carmo P. Nunes , Beatriz Santana Soares , Marcia M. Barbosa , Alexandre Varella Giannetti , Giancarlo Pereira Zille , Paulo Augusto Carvalho Miranda , Antonio Ribeiro-Oliveira Jr , Juliana Beaudette Drummond","doi":"10.1016/j.ghir.2021.101442","DOIUrl":"10.1016/j.ghir.2021.101442","url":null,"abstract":"<div><h3>Objective</h3><p>Cardiovascular (CV) disease is still a major cause of excessive morbidity and mortality in patients<span><span><span> with active acromegaly, which may be attributed to a high prevalence of associated pro-atherosclerotic risk factors. However, a direct effect of GH/IGF-1 excess on the </span>vasculature has been previously suggested, warranting further investigation. The present study was designed to investigate whether chronic GH/IGF-1 excess is associated with an increased prevalence of subclinical </span>atherosclerosis in patients with acromegaly.</span></p></div><div><h3>Design</h3><p><span>We measured carotid intima-media thickness (cIMT) and assessed carotid plaques by ultrasonography along with classical CV risk factors in 54 acromegaly patients (34 females, 50 ± 12 years and compared those with 62 (42 females, 53 ± 13 years) age-, sex- and CV risk factors- matched controls. In order to compare cIMT measurements between patients and controls we analyzed </span>common carotid artery far wall data as well as a combined measurement result, which consisted of the mean value of the six different measurements, three at each side.</p></div><div><h3>Results</h3><p><span><span>mean ± SD serum GH and IGF-1 levels were 2.76 ± 4.65 ng/mL and 1.7 ± 1.25 x ULN, respectively, in all acromegaly patients. Age, </span>body mass index<span>, blood pressure, lipid levels, fasting glucose and Framingham's global cardiovascular risk score classification were similar comparing patients and controls. Combined median [IQR] cIMT measurements were similar in acromegaly patients and matched controls (0.59 [0.52–0.66] mm vs. 0.59 [0.52–0.69] mm; </span></span><em>P</em> = 0.872) as well as in acromegaly patients with active and controlled disease (0.59 [0.51–0.68] mm vs. 0.60 [0.54–0.68] mm; <em>P</em> = 0.385). No significant correlations were observed between cIMT measurements and GH (Spearman <em>r</em> = 0.1, <em>P</em> = 0.49) or IGF-1 (Spearman <em>r</em> = 0.13, <em>P</em><span> = 0.37) levels in patients with acromegaly. Carotid atherosclerotic plaques prevalence was similar in patients and controls (26% vs. 32%; </span><em>P</em> = 0.54) as well as in patients with active and controlled acromegaly (22% vs. 30%; <em>P</em> = 0.537).</p></div><div><h3>Conclusions</h3><p>Our data suggest that GH/IGF-1 excess itself is not one of the main drivers of subclinical morphological atherosclerosis changes in patients with acromegaly and that optimal control of acromegaly-associated CV risk factors may preserve vasculature structure even when strict biochemical control is not achieved.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"62 ","pages":"Article 101442"},"PeriodicalIF":1.4,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39849349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1016/j.ghir.2021.101424
Deniz Kilic , Berkay Akmaz , Fahrettin Akay , Yusuf Ziya Guven , Guzide Gonca Oruk
Purpose
To investigate anterior segment parameters (ASPs) and dry eye disease (DED), including the status of the meibomian glands, in patients with acromegaly.
Methods
In this cross-sectional, comparative study, 36 acromegaly patients and 40 healthy sex- and age-matched controls were included. Participants received a comprehensive ophthalmological examination, including intraocular pressure measurements with Goldmann applanation tonometry (IOPGAT) and central corneal thickness corrected intraocular pressure (IOPCCT) measurements, and were evaluated for ASPs and DED. For ASPs, white-to-white (WTW), apical (ACT) and thinnest corneal thickness (TCT), corneal volume (CV), keratometry readings (K1, K2, and Kmean), anterior chamber depth (ACD) and volume (ACV), and iridocorneal angle (ICA) were obtained via Sirius topography. DED was assessed with Schirmer's test, tear breakup time (TBUT), and Ocular Surface Disease Index (OSDI) scores. Meibography scores (MSs) were obtained with the Sirius topography device.
Results
Patients had higher mean IOPGAT (P = .006), IOPCCT (P = .01), ACT (P = .024), and TCT (P = .005) but narrower ICA (P = .014) than controls. Although Schirmer's test did not differ between the groups (P = .442), patients had higher OSDI (P < .001), higher MS (P = .001), and shorter TBUT (P = .002).
Conclusion
Patients with acromegaly have greater IOP, greater corneal thickness, but narrower ICA than healthy individuals, as well as DED with increased MSs, which suggests meibomian gland dysfunction.
{"title":"Changes in anterior segment parameters and presence of dry eye disease in patients with acromegaly: A Sirius topography study combined with meibography","authors":"Deniz Kilic , Berkay Akmaz , Fahrettin Akay , Yusuf Ziya Guven , Guzide Gonca Oruk","doi":"10.1016/j.ghir.2021.101424","DOIUrl":"10.1016/j.ghir.2021.101424","url":null,"abstract":"<div><h3>Purpose</h3><p><span>To investigate anterior segment parameters (ASPs) and dry eye disease (DED), including the status of the meibomian glands, </span>in patients<span> with acromegaly.</span></p></div><div><h3>Methods</h3><p><span>In this cross-sectional, comparative study, 36 acromegaly patients and 40 healthy sex- and age-matched controls were included. Participants received a comprehensive ophthalmological examination, including intraocular pressure<span> measurements with Goldmann applanation tonometry (IOP</span></span><sub>GAT</sub>) and central corneal thickness corrected intraocular pressure (IOP<sub>CCT</sub><span>) measurements, and were evaluated for ASPs and DED. For ASPs, white-to-white (WTW), apical (ACT) and thinnest corneal thickness (TCT), corneal volume (CV), keratometry readings (K</span><sub>1</sub>, K<sub>2</sub>, and K<sub>mean</sub><span><span><span>), anterior chamber depth (ACD) and volume (ACV), and iridocorneal angle (ICA) were obtained via Sirius topography. DED was assessed with Schirmer's test, tear breakup time (TBUT), and </span>Ocular Surface Disease Index (OSDI) scores. </span>Meibography scores (MSs) were obtained with the Sirius topography device.</span></p></div><div><h3>Results</h3><p>Patients had higher mean IOP<sub>GAT</sub> (<em>P</em> = .006), IOP<sub>CCT</sub> (<em>P</em> = .01), ACT (<em>P</em> = .024), and TCT (<em>P</em> = .005) but narrower ICA (<em>P</em> = .014) than controls. Although Schirmer's test did not differ between the groups (<em>P</em> = .442), patients had higher OSDI (<em>P</em> < .001), higher MS (<em>P</em> = .001), and shorter TBUT (<em>P</em> = .002).</p></div><div><h3>Conclusion</h3><p>Patients with acromegaly have greater IOP, greater corneal thickness, but narrower ICA than healthy individuals, as well as DED with increased MSs, which suggests meibomian gland dysfunction.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"60 ","pages":"Article 101424"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ghir.2021.101424","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39320895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1016/j.ghir.2021.101425
Rafael Castellanos-Bueno , Alín Abreu-Lomba , Nathalia Buitrago-Gómez , Marcela Patiño-Arboleda , Doly Pantoja-Guerrero , Alex Valenzuela-Rincón , Henry M. Arenas-Quintero , Humberto I. Franco-Betancur , Alejandro Castellanos-Pinedo , Dinett Movilla-Castro , José M. Ocampo-Chaparro , Carlos A. Reyes-Ortiz , Alejandro Pinzón-Tovar
Aims
Describe the local characteristics, methodology and results of the registry of acromegalic patients in Colombia (RAPACO).
Methods
Multicenter, retrospective study based on the registry of acromegalic patients in Colombia: RAPACO. The data collected included: demographics, diagnosis, approximate time of disease evolution, data on weight, height, body mass index (BMI), neck circumference (NC) abdominal circumference (AC) hip circumference (HC) and waist/hip ratio (WHR); clinical and biochemical data at the time of diagnosis, etiology, immunohistochemistry of the tumor and information related to types of treatment. Descriptive analytics were employed.
Results
A total of 201 patients (60% females) with an average age at registration of 49.5 ± 14.6 years and an average time of evolution of the disease of 6.96 ± 4.5 years. Average weight was 75.1 Kg ± 12.98, with an average BMI of 28.11 ± 4.33. The most frequent symptoms mentioned at the time of diagnosis were extremity enlargement and headache. The most frequent comorbidity was arterial hypertension in 50.3% of the cases. 78.6% of cases were caused by macroadenoma. 80.1% received surgical treatment, 77.6% were under medical treatment, of which 95.7% were receiving somatostatin analogues. 26.4% of patients were treated with radiation therapy. Of the patients who received any type of clinical treatment, only 2.5% reported biochemical control at registration.
Conclusion
It is important to recognize the local epidemiological, clinical, biochemical and treatment characteristics in order to assist in further understanding this pathology to implement local measures to improve both the quality of life as well as the prognosis of the patients diagnosed.
{"title":"Clinical and epidemiological characteristics, morbidity and treatment based on the registry of acromegalic patients in Colombia: RAPACO","authors":"Rafael Castellanos-Bueno , Alín Abreu-Lomba , Nathalia Buitrago-Gómez , Marcela Patiño-Arboleda , Doly Pantoja-Guerrero , Alex Valenzuela-Rincón , Henry M. Arenas-Quintero , Humberto I. Franco-Betancur , Alejandro Castellanos-Pinedo , Dinett Movilla-Castro , José M. Ocampo-Chaparro , Carlos A. Reyes-Ortiz , Alejandro Pinzón-Tovar","doi":"10.1016/j.ghir.2021.101425","DOIUrl":"10.1016/j.ghir.2021.101425","url":null,"abstract":"<div><h3>Aims</h3><p>Describe the local characteristics, methodology and results of the registry of acromegalic patients in Colombia (RAPACO).</p></div><div><h3>Methods</h3><p>Multicenter, retrospective study based on the registry of acromegalic patients in Colombia: RAPACO. The data collected included: demographics, diagnosis, approximate time of disease evolution, data on weight, height, body mass index<span><span> (BMI), neck circumference<span> (NC) abdominal circumference<span> (AC) hip circumference (HC) and waist/hip ratio (WHR); clinical and biochemical data at the time of diagnosis, etiology, </span></span></span>immunohistochemistry<span> of the tumor and information related to types of treatment. Descriptive analytics were employed.</span></span></p></div><div><h3>Results</h3><p>A total of 201 patients (60% females) with an average age at registration of 49.5 ± 14.6 years and an average time of evolution of the disease of 6.96 ± 4.5 years. Average weight was 75.1 Kg ± 12.98, with an average BMI of 28.11 ± 4.33. The most frequent symptoms mentioned at the time of diagnosis were extremity enlargement and headache. The most frequent comorbidity was arterial hypertension in 50.3% of the cases. 78.6% of cases were caused by macroadenoma<span>. 80.1% received surgical treatment, 77.6% were under medical treatment, of which 95.7% were receiving somatostatin analogues. 26.4% of patients were treated with radiation therapy. Of the patients who received any type of clinical treatment, only 2.5% reported biochemical control at registration.</span></p></div><div><h3>Conclusion</h3><p>It is important to recognize the local epidemiological, clinical, biochemical and treatment characteristics in order to assist in further understanding this pathology to implement local measures to improve both the quality of life as well as the prognosis of the patients diagnosed.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"60 ","pages":"Article 101425"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ghir.2021.101425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39330066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It was the aim of this study to evaluate illness-related burdens and support needs of patients with acromegaly to identify hitherto unadressed research questions and to open up avenues for improvements in patient care. This was done by using the focus group approach as a qualitative research method.
Design
Seven patients with acromegaly took part in a focus group moderated by an external medical communication specialist. The discourse focused on topics such as impact of the illness on everyday life, support needs and personal resources. The discussion was recorded and transcribed and analyzed by qualitative content analysis.
Results
Participants reported a huge impact of acromegaly on daily life, ranging from time expenditure for managing their illness, to bodily and mental sequelae and strain caused by physical disfigurement. Patients' coping strategies included family support, physical activities and humor. The participants wished for a sound patient-doctor relationship, more interdisciplinary and holistic treatment, medical rehabilitation services with special knowledge on acromegaly-related morbidity, a stable contact person in the medical process and reliable information material for themselves and their relatives.
Conclusions
The results provide multi-facetted impressions of the overwhelming impact of acromegaly and unmet support needs of the afflicted patients. Further quantitative research is necessary to examine the generalisibility of the present results in order to implement tailored support measures. We suggest to develop standardized questionnaires to explore the prevalence and severity of the addressed problems in a large patient sample and to establish screening instruments to monitor disease burden in clinical practice.
{"title":"Illness-related burden, personal resources and need for support in patients with acromegaly: Results of a focus group analysis","authors":"Sonja Siegel , Cedric Fabian Kirstein , Bernadette Schröder , Nicole Unger , Ilonka Kreitschmann-Andermahr","doi":"10.1016/j.ghir.2021.101422","DOIUrl":"10.1016/j.ghir.2021.101422","url":null,"abstract":"<div><h3>Objective</h3><p><span>It was the aim of this study to evaluate illness-related burdens and support needs of patients with acromegaly to identify hitherto unadressed research questions and to open up avenues for improvements </span>in patient care. This was done by using the focus group approach as a qualitative research method.</p></div><div><h3>Design</h3><p>Seven patients with acromegaly took part in a focus group moderated by an external medical communication specialist. The discourse focused on topics such as impact of the illness on everyday life, support needs and personal resources. The discussion was recorded and transcribed and analyzed by qualitative content analysis.</p></div><div><h3>Results</h3><p>Participants reported a huge impact of acromegaly on daily life, ranging from time expenditure for managing their illness, to bodily and mental sequelae<span><span> and strain caused by physical disfigurement. Patients' coping strategies included family support, physical activities and humor. The participants wished for a sound patient-doctor relationship, more interdisciplinary and holistic </span>treatment, medical rehabilitation services with special knowledge on acromegaly-related morbidity, a stable contact person in the medical process and reliable information material for themselves and their relatives.</span></p></div><div><h3>Conclusions</h3><p>The results provide multi-facetted impressions of the overwhelming impact of acromegaly and unmet support needs of the afflicted patients. Further quantitative research is necessary to examine the generalisibility of the present results in order to implement tailored support measures. We suggest to develop standardized questionnaires to explore the prevalence and severity of the addressed problems in a large patient sample and to establish screening instruments to monitor disease burden in clinical practice.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"60 ","pages":"Article 101422"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ghir.2021.101422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39332552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1016/j.ghir.2021.101431
Guadalupe Vargas-Ortega , Carlos Alfonso Romero-Gameros , Mario Enrique Rendón-Macias , Lourdes Balcázar-Hernández , Ernesto Sosa-Eroza , Moises Mercado , Ana L. Espinosa de los Monteros-Sánchez , Barbara Pérez-Aguilar , Carlos Paredes-Manjarrez , Fernando Bernardo Reyes-Olhagaray , Diana Laura Serrano-Ramírez , Erick Vladimir Martínez-De la Cruz , Baldomero González-Virla
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.
甲状腺肿在肢端肥大症患者中很常见;它的发展与疾病的持续时间有关。甲状腺细胞表达IGF-1受体,TSH/IGF-1相互作用已被证明在甲状腺细胞生长中具有协同作用。肢端肥大症患者IGF-1水平与甲状腺体积之间存在相关性。本研究的目的是通过对肢端肥大症患者的回顾性病例队列研究来评估该人群中甲状腺结节疾病的相关危险因素。方法采用病例队列研究,根据年龄、性别和诊断时的生长激素进行匹配。病例包括在随访中出现甲状腺结节的肢端肥大症患者,对照组包括没有甲状腺结节的肢端肥大症患者。对肢端肥大症患者甲状腺结节病的相关危险因素进行Cox比例风险估计。使用Kaplan-Meier分析估计甲状腺结节无病生存分析。结果纳入病例49例,对照组56例。在多变量Cox比例风险分析中,年龄和IGF-1 ≥ 2.2 x ULN与甲状腺结节的存在显著相关[HR为2.21 (95% CI;1.15 - -4.25, p = 0.01)]。Kaplan-Meier生存分析显示,IGF-1 X ULN ≥ 2.2患者的无结节生存率低于IGF-1 X ULN < 2.2患者。结论IGF-1 X ULN ≥ 2.2的肢端肥大症患者发生甲状腺结节病的可能性更大,提示暴露于IGF-1轴高活动的时间与甲状腺结节的发生可能存在直接影响。
{"title":"Risk factors associated with thyroid nodular disease in acromegalic patients: A case-cohort study in a tertiary center","authors":"Guadalupe Vargas-Ortega , Carlos Alfonso Romero-Gameros , Mario Enrique Rendón-Macias , Lourdes Balcázar-Hernández , Ernesto Sosa-Eroza , Moises Mercado , Ana L. Espinosa de los Monteros-Sánchez , Barbara Pérez-Aguilar , Carlos Paredes-Manjarrez , Fernando Bernardo Reyes-Olhagaray , Diana Laura Serrano-Ramírez , Erick Vladimir Martínez-De la Cruz , Baldomero González-Virla","doi":"10.1016/j.ghir.2021.101431","DOIUrl":"10.1016/j.ghir.2021.101431","url":null,"abstract":"<div><h3>Introduction</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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, <em>p</em> = 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.</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"60 ","pages":"Article 101431"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S109663742100054X/pdfft?md5=941b7c9a12f9cb19cf3a9e231a118894&pid=1-s2.0-S109663742100054X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39699020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children with Growth Hormone deficiency (GHD) are prone to heart dysfunction and, if left untreated, will result in marked cardiac dysfunction in adulthood. The aim was to evaluate the effect of GHD and growth hormone (GH) therapy on cardiac structure in children and adolescents, and to investigate the role of insulin like growth factor-1 (IGF-1) in this.
Methods
M-mode, pulse-wave Doppler echocardiography and tissue Doppler imaging (TDI) were performed in 49 children with GHD who were divided into those with a peak GH response < 7 μg/L and 7–10 μg/L after two GH stimulation tests, aged 8–16 years at baseline and at six and 12 months after GH initiation, and 49 healthy peers. IGF-1 concentration was measured.
Results
Although the left ventricular end diastolic and systolic diameters in both GH deficient groups were significantly lower than controls (p < 0.01), both diameters increased significantly with one year of treatment and achieved normal values (p > 0.05). Using TDI in both two patients group revealed increased E/A, prolonged isovolumic relaxation time, shortened ejection time, and a significant increase in myocardial performance index compared to controls (p < 0.001). Significant improvement was observed in these parameters from the sixth month of GH treatment (p < 0.001), this improvement does not match parameters measured in healthy peers, even after one year of treatment in both patients group. (p < 0.001). No correlation was found between IGF-1 concentration and any echocardiographic parameter.
Conclusion
Echocardiographic parameters were similar in children with a GH peak < 7 μg/L and 7–10 μg/L. In TDI, both systolic and diastolic function was impaired in GHD children compared to controls. These parameters improved after one year of GH therapy but did not recover to healthy control levels.
{"title":"Cardiac functions in children with growth hormone deficiency: Effects of one year of GH replacement therapy","authors":"Fatos Alkan , Betul Ersoy , Deniz Ozalp Kızılay , Senol Coskun","doi":"10.1016/j.ghir.2021.101432","DOIUrl":"10.1016/j.ghir.2021.101432","url":null,"abstract":"<div><h3>Introduction</h3><p>Children with Growth Hormone deficiency (GHD) are prone to heart dysfunction and, if left untreated, will result in marked cardiac dysfunction in adulthood. The aim was to evaluate the effect of GHD and growth hormone (GH) therapy on cardiac structure in children and adolescents, and to investigate the role of insulin like growth factor-1 (IGF-1) in this.</p></div><div><h3>Methods</h3><p><span>M-mode, pulse-wave Doppler echocardiography and </span>tissue Doppler imaging (TDI) were performed in 49 children with GHD who were divided into those with a peak GH response < 7 μg/L and 7–10 μg/L after two GH stimulation tests, aged 8–16 years at baseline and at six and 12 months after GH initiation, and 49 healthy peers. IGF-1 concentration was measured.</p></div><div><h3>Results</h3><p>Although the left ventricular end diastolic and systolic diameters in both GH deficient groups were significantly lower than controls (<em>p</em><span> < 0.01), both diameters increased significantly with one year of treatment and achieved normal values (</span><em>p</em><span><span> > 0.05). Using TDI in both two patients group revealed increased E/A, prolonged isovolumic relaxation time, shortened </span>ejection time, and a significant increase in myocardial performance index compared to controls (</span><em>p</em> < 0.001). Significant improvement was observed in these parameters from the sixth month of GH treatment (p < 0.001), this improvement does not match parameters measured in healthy peers, even after one year of treatment in both patients group. (<em>p</em> < 0.001). No correlation was found between IGF-1 concentration and any echocardiographic parameter.</p></div><div><h3>Conclusion</h3><p>Echocardiographic parameters were similar in children with a GH peak < 7 μg/L and 7–10 μg/L. In TDI, both systolic and diastolic function was impaired in GHD children compared to controls. These parameters improved after one year of GH therapy but did not recover to healthy control levels.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"60 ","pages":"Article 101432"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39841186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1016/j.ghir.2021.101430
Shivani Vekaria , Fei Chen , Elcin Zan , Christopher William , Chandra Sen , Richard Lebowitz , David Zagzag , Floyd A. Warren , Tamar C. Brandler , Nidhi Agrawal
Objective
Pituitary carcinoma is a rare tumor, defined as a tumor of adenohypophyseal cells with systemic or craniospinal metastasis. We present a case of a growth hormone (GH)-secreting pituitary carcinoma with a review of literature to better characterize this disease.
Design
Case report and literature review of 25 cases of GH-secreting pituitary carcinomas
Results
The age of diagnosis of GH-secreting carcinomas ranged 24–69 years old with a mean age of 44.4 with 52% of cases present in females. Mean latency period between diagnosis of acromegaly and transition to pituitary carcinoma was 11.4 years with mean survival being 3.4 years.
Conclusion
Growth hormone (GH)-secreting pituitary carcinomas are rare and hard to distinguish from aggressive pituitary adenomas. From review of literature, treatment options include debulking surgery, radiotherapy, or chemotherapy with dismal outcomes. There are no diagnostic markers or features which can predict metastatic progression of these tumors. Future studies with genomic landscapes and relevant tumor markers are needed to identify pituitary tumors most likely to metastasize.
{"title":"Growth hormone secreting pituitary carcinomas: Case report and review of literature","authors":"Shivani Vekaria , Fei Chen , Elcin Zan , Christopher William , Chandra Sen , Richard Lebowitz , David Zagzag , Floyd A. Warren , Tamar C. Brandler , Nidhi Agrawal","doi":"10.1016/j.ghir.2021.101430","DOIUrl":"10.1016/j.ghir.2021.101430","url":null,"abstract":"<div><h3>Objective</h3><p>Pituitary carcinoma is a rare tumor, defined as a tumor of adenohypophyseal cells with systemic or craniospinal metastasis. We present a case of a growth hormone (GH)-secreting pituitary carcinoma with a review of literature to better characterize this disease.</p></div><div><h3>Design</h3><p>Case report and literature review of 25 cases of GH-secreting pituitary carcinomas</p></div><div><h3>Results</h3><p>The age of diagnosis of GH-secreting carcinomas ranged 24–69 years old with a mean age of 44.4 with 52% of cases present in females. Mean latency period between diagnosis of acromegaly and transition to pituitary carcinoma was 11.4 years with mean survival being 3.4 years.</p></div><div><h3>Conclusion</h3><p><span>Growth hormone (GH)-secreting pituitary carcinomas are rare and hard to distinguish from aggressive pituitary adenomas<span><span>. From review of literature, treatment options include </span>debulking surgery, radiotherapy, or chemotherapy with dismal outcomes. There are no diagnostic markers or features which can predict metastatic progression of these tumors. Future studies with genomic landscapes and relevant tumor markers are needed to identify </span></span>pituitary tumors most likely to metastasize.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"60 ","pages":"Article 101430"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39484904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}