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Systemic comorbidities of acromegaly in real-life experience: which difference among young and elderly patients?

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Abstract

Introduction

Acromegaly is a rare but potentially life-threatening disease, if not promptly managed, for the systemic complications due to the GH/IGF-I hypersecretion. According to the increased population life span, the number of older acromegaly patients is growing. We aim to investigate clinical features of elderly acromegaly (elderly-ACRO) and to identify the risk factors for the occurrence of comorbidities in elderly-ACRO.

Materials and methods

A retrospective and multi-center study was performed on acromegaly patients. Acromegaly comorbidities were compared among elderly-ACRO (>65 years), young acromegaly patients (young-ACRO if ≤65 years) and a control group of age and gender-matched subjects.

Result

Fifty of the 189 enrolled patients were elderly-ACRO (26.5%). Cardiovascular, metabolic, neurological/psychiatric and joint/articular disorders, nodular thyroid disease, sleep apnoea syndrome and skeletal fragility occurred more frequently in elderly-ACRO as compared to controls. Cardiovascular and metabolic disorders, nodular thyroid disease occurred significantly more frequently in elderly-ACRO as compared to young-ACRO and controls. On the other hand, neurological/psychiatric, joint/articular disorders and bone fragility occur with a similar frequency among elderly and young-ACRO. We found that elderly-ACRO had an increased risk for the occurrence of systemic arterial hypertension (p < 0.001, OR: 5.4 95%IC:2.6–10.9), left ventricular hypertrophy (p = 0.01, OR: 3 95%IC: 1.5–5.8) and metabolic disorders (p = 0.006, OR: 4.1 95%IC: 2–8.3).

Conclusion

Our results may suggest that some acromegaly comorbidities may be predominantly due to acromegaly “per-se” rather than to aging. On the contrary, cardiovascular and metabolic disorders seem to be due to aging as well.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Pituitary Unit, Department of Endocrinology and Metabolism, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy

    Sabrina Chiloiro, Antonella Giampietro, Valeria Epifani, Domenico Milardi, Alfredo Pontecorvi, Laura De Marinis & Antonio Bianchi

  2. Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy

    Sabrina Chiloiro, Antonella Giampietro, Valeria Epifani, Domenico Milardi, Alfredo Pontecorvi, Laura De Marinis & Antonio Bianchi

  3. Section of Endocrinology, Geriatrics & Internal Medicine, Dept of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64/B, 44121, Ferrara, Italy

    Irene Gagliardi, Marta Bondanelli, Maria Rosaria Ambrosio & Maria Chiara Zatelli

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All procedures performed in the study were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by Institutional Review Board of the Gemelli Hospital, Catholic University of the Sacred Heart, Rome, and of Azienda Ospedaliera Universitaria of Ferrara.

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Chiloiro, S., Giampietro, A., Gagliardi, I. et al. Systemic comorbidities of acromegaly in real-life experience: which difference among young and elderly patients?. Endocrine 80, 142–151 (2023). https://doi.org/10.1007/s12020-022-03261-y

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