Acromegaly is an insidious disorder characterized by excess growth hormone secretion as well as IGF-1. However, data on the clinical presentation and outcome of patients from the South Asian region is scarce.
By following up on patients at one of the main tertiary care endocrine clinic in the nation, this study seeks to close the information gaps about acromegaly in the local context.
A cross-sectional, descriptive study was conducted at the Endocrine clinic at the National Hospital of Sri Lanka recruiting patients with acromegaly followed up at the clinic consecutively.
From 112 patients 53.6% (60) were female. Mean age was 55.09 (±12.5) years while the mean age at diagnosis was 43.4 (±6.7). Mean duration of follow-up was 11.5 (±6.7) years. Mean BMI was 27.16(±4.9) kg/m2. Diabetes, hypertension, and dyslipidemia were seen in 36.6%, 39.3%, and 19.6% respectively. Most presented with changes in facial appearance (78.6%) followed by soft tissue swelling (70.5%). Symptoms due to pituitary adenoma including headache and visual changes were seen among 57.1% and 24.1% respectively. Complications such as osteoarthritis, arthropathy, carpal tunnel syndrome, arrhythmia, and chronic polyps were seen in 23.25%, 20.5%, 18.8% 5.4%, and 4.5%. Mean IGF-1 at presentation was 790.36(±1115.96) ng/ml which significantly reduced to 433.72 (± 353.1) ng/ml (P – 0.0044) post-treatment along with mean Growth hormone day curve value which reduced from 26.12(± 17.1) mIU/L to 19.23(±17.6) mIU/L (P- 0.0095) Mean GH following OGTT was 27.71(±22.23) ng/ml.77.7% had macroadenomas and 83% underwent TSS as the first surgery. 8% had repeat surgery. 62.5% (70) were treated with cabergoline and 12.5% (14) with octreotide. 1 participant with resistant acromegaly is currently treated with pegvisomant. 27.7% are cured at present.
Despite the significant reduction in IGF-1 following surgery, further research is necessary to improve management and outcomes given the poor prognosis and complications.