engleski

Glucose tolerance in acromegaly

Acromegaly is a rare disorder characterized by hypersecretion of growth hormone (GH), and in more than 99 percent of cases is due to a functioning pituitary adenoma. It is associated with an increased incidence of cardiovascular disease and several disturbances in intermediary metabolism, including insulin resistance, hyperinsulinaemia and increased metabolic rate. 20 percent of acromegalic patients are diabetic and 40 percent have impaired glucose tolerance (IGT). Overall mortality in acromegaly is approximately double that found in general population. Of ninety-eight (98) pituitary adenoma patients admitted to our Department during the period from 1991-1997, fifteen (15/98, 15.3 percent) had GH-secreting pituitary adenoma. The mean age of the patients was 49.9+-10.4. There were eight women (BMI 32.0+-4.2 kg/m2) and seven men (BMI 28.5+-3.6 kg/m2). Six patients had micro- and nine patients had macro-adenoma as revealed by CT or MRI. Mean basal plasma GH concentration was 29.7+-24.6 mIU/L (normal range less than 0.3-14 mIU/L). A 100-g oral glucose tolerance test (OGTT) failed to supress the plasma GH to less than 4.0 mIU/L in all patients. Eight of 15 patients had increased fasting blood glucose levels. Two female patients had a history of diabetes mellitus (DM) for 3 and 11 years before acromegaly was diagnosed and they had both taken oral antidiabetics. The OGTT identified 4 out of 15 patients with IGT (26.6 percent) and the same number of patients with DM. Our results show the significant number of acromegalic patients with IGT or DM.

acromegaly; diabetes mellitus; impaired glucose tolerance

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