Sex difference in patients with controlled acromegaly-A multicentre survey

Jakob Dal*, Christian Rosendal, Jesper Karmisholt, Ulla Feldt-Rasmussen, Marianne S. Andersen, Marianne Klose, Claus Feltoft, Ansgar Heck, Eigil H. Nielsen, Jens O. L. Jørgensen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

4 Citations (Scopus)
30 Downloads (Pure)

Abstract

OBJECTIVE: Active acromegaly is subject to sex differences in growth hormone (GH) and Insulin like growth factor 1 (IGF-I) patterns as well as clinical features but whether this also pertains to controlled disease is unclear.

DESIGN: In a cross-sectional, multi-centre study, 84 patients with acromegaly (F = 43, M = 41), who were considered controlled after surgery alone (n = 23) or during continued somatostatin receptor ligand (SRL) treatment (n = 61), were examined.

METHODS: Serum concentrations of GH, insulin, glucose and free fatty acid (FFA) were measured during an oral glucose tolerance test (OGTT) together with baseline serum IGF-I and completion of two HR-Qol questionnaires (acromegaly quality of life questionnaire [AcroQol] and Patient-assessed Acromegaly Symptom Questionnaire [PASQ]).

RESULTS: The mean age at the time of the study was 57 (±1.1) years and the majority of females (were postmenopausal. Females had significantly higher fasting GH but comparable IGF-I standard deviation scores (SDS). Using fasting GH < 1.0 µg/L as cut off, disease control was less prevalent in females (F: 56% vs. M: 83%, p = .007) whereas a comparable figure was observed using IGF-I SDS < 2 (F:79% vs. M:76%, p = .71). Compared with males, female patients showed impaired AcroQol physical score (p = .05), higher fasting FFA (p = .03) and insulin concentrations during the OGTT (p = .04).

CONCLUSION: In patients with acromegaly considered controlled, postmenopausal females exhibited higher GH levels than males despite comparable IGF-I levels, which also translated into impaired metabolic health and well-being. Our findings point to the relevance of including GH measurements in the assessment of disease control and suggest that disease-specific sex differences prevail after treatment.

Original languageEnglish
JournalClinical Endocrinology
Volume98
Issue number1
Pages (from-to)74-81
Number of pages8
ISSN0300-0664
DOIs
Publication statusPublished - Jan 2023

Bibliographical note

© 2022 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd.

Keywords

  • FFA
  • GH
  • IGF-I
  • acromegaly
  • age
  • insulin
  • pituitary adenoma
  • quality of life
  • sex

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