Clinical features and therapeutic outcomes of 65 patients with acromegaly at Tokyo Women's Medical University

Objective The purpose of this study was to survey the clinical characteristics, complications, and therapeutic outcome in patients with acromegaly. Patients and Methods The clinical features of 65 patients with acromegaly (31 males, 34 females; mean age: 50 +/-2 yr.) who were admitted to Tokyo Women's Medical University between 1990 and 1999 were analyzed retrospectively from medical records. Results The retrospective analysis revealed that the diagnosis of acromegaly was preceded by approximately 8.1 1.1 years of signs and symptoms of the disease. Forty-six of the 65 patients (71 %) had macroadenomas,16 (25 %) had microadenomas, and the remaining three had empty sella. The rate of biochemical cure or remission was 81 % for microadenoma (13/16), 64% for macroadenoma without extrasellar extension (9/14), and 13% for macroadenoma with cavernous sinus extension (2/15). Eighteen (28 %) patients had impaired glucose tolerance (IGT) and 32 (49 %) had diabetes mellitus (DM). After treatment for acromegaly, glucose metabolism was analyzed again in 38 patients, and it improved in 26 patients with IGT or DM. Twenty-five of 65 patients (38%) had hypertension. Of 26 patients who underwent barium enema or colonoscopy, 10 had colonic polyps and 4 had colon cancer. Conclusion This study suggests that long-term excessive growth hormone (GH) secretion causes many complications. Therefore, awareness of the early symptoms and signs of acromegaly and long-term careful management of complications, along with therapy to reduce serum GH/insulin-like growth factor (IGF)-I levels, are important for patients with acromegaly.