Frequency of acromegaly in hospitalized patients with type 2 diabetes and its significance

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 88-129-Acromegaly & Prolactinoma
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-104
Kentaro Suda*1, Hidenori Fukuoka2, Genzo Iguchi2, Naoko Hashimoto2, Yushi Hirota2, Hironori Bando1, Masaaki Yamamoto1, Hitoshi Nishizawa1, Michiko Takahashi1, Kazuhiko Sakaguchi2 and Yutaka Takahashi1
1Kobe University Graduate School of Medicine, Kobe, Japan, 2Kobe University Hospital, Kobe, Japan
The prevalence of acromegaly is estimated to be approximately 8-24/100,000, but several recent studies suggest that this rate might be underestimated. The aim of this retrospective study was to evaluate the frequency of acromegaly in hospitalized patients with type 2 diabetes (T2DM). A total of 162 hospitalized patients (97 male and 65 female) with T2DM in Kobe University Hospital from 2011 to 2012 were enrolled. Four patients with pituitary disease and 2 pregnant women were excluded. For the screening, serum IGF-I level was measured and, if elevated, the measurement of serum GH levels in the oral glucose tolerance test (OGTT) was carried out. Patients with elevated serum IGF-I levels and inadequate suppression of GH in the OGTT were submitted to magnetic resonance imaging (MRI). Acromegaly was not suspected by physician in any of the patients at the time of admission. Mean HbA1c, serum GH levels, serum IGF-I levels, and IGF-I SD score were 8.1±2.1 %, 1.3±3.4 ng/mL, 159.4±159.3 ng/mL, 0.00±2.44, respectively. As a result, 13 patients (8.3%) had elevated serum IGF-I levels (mean IGF-I SD score was 2.86±0.87) and 4 patients (2.6%) had inadequate suppression of GH in the OGTT. Pituitary adenoma was detected by MRI in 2 patients (1.3%), and these subjects presented mild acromegalic phenotype in the face and hands. These patients were not submitted to transsphenoidal surgery because of their age. Intriguingly, both these patients had severe macrovascular complications, such as an ischemic heart disease and arteriosclerosis obliterans in spite of the relatively mild microvascular complications and low grade of the other risk factors, suggesting that a presence of acromegaly played a role in the progression of complications of atherosclerosis. Although a large-scale analysis is necessary, the present results suggest that it is useful to screen by serum IGF-I levels in these patients and the prevalence of acromegaly may be higher among hospitalized patients with T2DM than that has previously been reported. Because acromegaly causes diabetes and a complication of diabetes with acromegaly deteriorates its prognosis, a careful screening for acromegaly in T2DM is warranted.

Nothing to Disclose: KS, HF, GI, NH, YH, HB, MY, HN, MT, KS, YT

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