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Adrenal morphology and function in acromegalic patients in relation to disease activity

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Abstract

Visceromegaly is a common consequence of acromegaly. However, few studies investigated the chronic effects of growth hormone on adrenal glands. Our aim was to evaluate adrenal morphology and function in a cohort of acromegalic patients in relation to disease activity. Twenty-six acromegalics (10 males and 16 females) and 21 healthy subjects were investigated. Gland morphology was evaluated by computerized axial tomography, measuring central, lateral, and medial adrenal segments. Uncontrolled acromegalics showed increased volume of all adrenal segments, higher urinary free cortisol (UFC), and lower morning adrenocorticotropic hormone in comparison with healthy subjects. However, normal cortisol levels after low-dose dexamethasone suppression test indicated a preserved regulation of the hypothalamic–pituitary–adrenal axis. In addition, uncontrolled patients showed greater medial segment of right gland, higher UFC, and aldosterone levels with respect to controlled patients. All acromegalics did not show any difference in adrenal size when grouped according to UFC/24 h levels. In addition, no difference was found in any of the parameters between normotensive and hypertensive patients. In conclusion, our findings confirm that acromegaly affects adrenal size as well as other organs. In addition, we report a stimulatory effect of growth hormone on adrenal function, although the regulation of the hypothalamic–pituitary–adrenal axis is preserved.

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References

  1. A. Colao, P. Marzullo, C. Di Somma, G. Lombardi, Growth hormone and the heart. Clin. Endocrinol. (Oxf) 54, 137–154 (2001)

    Article  CAS  Google Scholar 

  2. A.J. Sober, P. Gorden, J. Roth, T.W. AvRuskin, Visceromegaly in acromegaly. Evidence that clinical hepatomegaly or splenomegaly (but not sialomegaly) are manifestations of a second disease. Arch. Intern. Med. 134(3), 415–417 (1974)

    Article  CAS  PubMed  Google Scholar 

  3. M. Gasperi, E. Martino, L. Manetti, M. Arosio, S. Porretti, G. Faglia, S. Mariotti, A.M. Colao, G. Lombardi, R. Baldelli, F. Camanni, A. Liuzzi, Acromegaly Study Group of the Italian Society of Endocrinology, Prevalence of thyroid diseases in patients with acromegaly: results of an Italian multi-center study. J. Endocrinol. Invest. 25(3), 240–245 (2002)

    CAS  PubMed  Google Scholar 

  4. M.D. Coyne, Effect of growth hormone and corticotrophin on steroidogenesis in cultured rat adrenocortical cells. Horm. Res. 19(3), 185–190 (1984)

    Article  CAS  PubMed  Google Scholar 

  5. C. Fottner, D. Engelhardt, M.M. Weber, Regulation of steroidogenesis by insulin-like growth factors (IGFs) in adult human adrenocortical cells: IGF-I and, more potently, IGF-II preferentially enhance androgen biosynthesis through interaction with the IGF-I receptor and IGF-binding proteins. J. Endocrinol. 158(3), 409–417 (1998)

    Article  CAS  PubMed  Google Scholar 

  6. P. Michl, D. Engelhardt, R. Oberneder, M.M. Weber, Growth hormone has no direct effect on human adrenal steroid and insulin-like growth factor-binding protein secretion. Endocr. Res. 25(3–4), 281–293 (1999)

    Article  CAS  PubMed  Google Scholar 

  7. P.E. Cryer, Plasma norepinephrine and epinephrine in acromegaly. J. Clin. Endocrinol. Metab. 41, 542–545 (1975)

    Article  CAS  PubMed  Google Scholar 

  8. G. Deray, P. Chanson, G. Maistre, A. Warnet, J. Eurin, C. Barthelemy, F. Masson, F. Martinez, J. Lubetzki, J.C. Legrand, Atrial natriuretic factor in patients with acromegaly. Eur. J. Clin. Pharmacol. 38, 409–413 (1990)

    Article  CAS  PubMed  Google Scholar 

  9. C.M. Ritchie, B. Sheridan, R. Fraser, D.R. Hadden, A.L. Kennedy, J. Riddell, A.B. Atkinson, Studies on the pathogenesis of hypertension in Cushing’s disease and acromegaly. Q. J. Med. 76, 855–867 (1990)

    CAS  PubMed  Google Scholar 

  10. G.R. Van Loon, Abnormal plasma catecholamine response in acromegalics. J. Clin. Endocrinol. Metab. 48, 784–789 (1979)

    Article  PubMed  Google Scholar 

  11. J.A. McKnight, D.R. McCance, D.R. Hadden, L. Kennedy, G. Robert, B. Sheridan, A.B. Atkinson, Basal and saline-stimulated levels of plasma atrial natriuretic factor in acromegaly. Clin. Endocrinol. (Oxf) 31, 431–438 (1989)

    Article  CAS  Google Scholar 

  12. J. Baughan, C. de Gara, D. Morrish, A rare association between acromegaly and pheochromocytoma. Am. J. Surg. 182(2), 185–187 (2001)

    Article  CAS  PubMed  Google Scholar 

  13. C. Scaroni, R. Selice, S. Benedini, E. De Menis, M. Arosio, C. Ronchi, M. Gasperi, L. Manetti, G. Arnaldi, B. Polenta, M. Boscaro, N. Albiger, E. Martino, F. Mantero, Adrenal morpho-functional alterations in patients with acromegaly. J. Endocrinol. Invest. 31(7), 602–606 (2008)

    CAS  PubMed  Google Scholar 

  14. A. Giustina, A. Barkan, F.F. Casanueva, F. Cavagnini, L. Frohman, K. Ho, J. Veldhuis, J. Wass, K. Von Werder, S. Melmed, Criteria for cure of acromegaly: a consensus statement. J. Clin. Endocrinol. Metab. 85(2), 526–529 (2000)

    Article  CAS  PubMed  Google Scholar 

  15. D.R. Matthews, J.P. Hosker, A.S. Rudenski, B.A. Naylor, D.F. Treacher, R.C. Turner, Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28, 412–419 (1985)

    Article  CAS  PubMed  Google Scholar 

  16. D.J. Sahn, A. Demaria, J. Kisslo, A. Weyman, The Committee on M-Mode Standardization of the American Society of Echocardiography: recommendations regarding quantitation in M-Mode echocardiography: results of a survey study of echocardiography measurements. Circulation 58, 1072–1083 (1978)

    CAS  PubMed  Google Scholar 

  17. European Society of Hypertension-European Society of Cardiology Guidelines Committee, 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J. Hypertens. 21(6), 1011–1053 (2003)

    Article  Google Scholar 

  18. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 20, 1183–1197 (1997)

    Google Scholar 

  19. Third Report of the National Cholesterol Education Panel (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel or ATP III). NIH Publication No. 01-3305, May 2001

  20. G.G. Sleilati, K.T. Kovacs, M. Honasoge, Acromegaly and pheochromocytoma: report of a rare coexistence. Endocr. Pract. 8(1), 54–60 (2002)

    PubMed  Google Scholar 

  21. R.J. Anderson, E.G. Lufkin, G.W. Sizemore, J.A. Carney, S.G. Sheps, Y.E. Silliman, Acromegaly pituitary adenoma with phaeochromocytoma: a variant of multiple endocrine neoplasia. Clin. Endocrinol. (Oxf) 14(6), 605–612 (1981)

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Section of Endocrinology, DOSAC (Dipartimento di Oncologia Sperimentale ed Applicazioni Cliniche), University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy

    Alessandro Ciresi, Marco C. Amato, Calogero Vetro, Aldo Galluzzo & Carla Giordano

  2. Endocrinology, Ospedale Villa Sofia, Palermo, Italy

    Renato Lo Coco

Authors
  1. Alessandro Ciresi
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  2. Marco C. Amato
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  3. Calogero Vetro
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  4. Renato Lo Coco
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  5. Aldo Galluzzo
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  6. Carla Giordano
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Correspondence to Carla Giordano.

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Ciresi, A., Amato, M.C., Vetro, C. et al. Adrenal morphology and function in acromegalic patients in relation to disease activity. Endocr 36, 346–354 (2009). https://doi.org/10.1007/s12020-009-9230-y

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