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Peripheral nervous system assessment in acromegaly patients under somatostatin analogue therapy

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Abstract

Purpose

Acromegaly is known to affect peripheral nervous system (PNS) causing carpal tunnel syndrome (CTS) and polyneuropathy. The frequency of these disorders and the evaluation methods vary among studies. In the present study, we aimed to examine PNS of acromegaly patients under somatostatin analogue (SSA) therapy.

Methods

Forty-eight acromegaly patients (26 F/22 M, 45.58 ± 11.6 years) under SSA treatment and 44 healthy controls (25 F/19 M, 47.46 ± 8.7 years) were assessed by symptom questionnaires, neurologic examination and electrophysiological studies.

Results

87.5 % of the acromegaly patients had at least one abnormal finding regarding PNS. With the incorporation of palm–wrist median nerve conduction velocity method, we detected CTS in 50 % of patients. Polyneuropathy was less frequent (29.2 %). Both conditions were independent from the coexisting diabetes mellitus (p = 0.22 for CTS, p = 0.71 for polyneuropathy). Polyneuropathy but not CTS was more common among biochemically uncontrolled acromegaly patients rather than those under control (p = 0.03; p = 0.68, respectively).

Conclusion

Our findings emphasize the high prevalence of peripheral nervous system involvement in acromegaly patients under SSA therapy and importance of neurological evaluation of these patients. Early diagnosis and treatment of the disease may reduce the PNS involvement.

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Abbreviations

BMI:

Body mass index

CMAP:

Compound motor action potential

CSA:

Cross-sectional areas

CTS:

Carpal tunnel syndrome

DM:

Diabetes mellitus

DN4:

Douleur neuropathique 4

ENMG:

Electroneuromyography

GH:

Growth hormone

HPLC:

High-performance liquid chromatograph

IGF-1:

Insulin-like growth factor-1

MDL:

Motor distal latency

NCS:

Nerve conduction studies

NCV:

Nerve conduction velocity

PNS:

Peripheral nervous system

SD:

Standard deviation

SNAP:

Sensory nerve action potential

UV/VIS:

Ultraviolet–visible

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Acknowledgments

We thank Dr. Arif Koytak for his devoted contribution in the statistical analyses and Dr. Ali Yaman for his cooperation in the laboratory assessment of the participants.

Funding

The study was funded by Scientific Research and Projects Committee of Marmara University and by the investigators themselves.

Author information

Authors and Affiliations

  1. Department of Neurology, Marmara University School of Medicine, Fevzi Cakmak Mah. Muhsin Yazicioglu Cad. No: 10 Pendik, 34899, Istanbul, Turkey

    H. Alibas, P. Kahraman Koytak, T. Tanridag & K. Uluc

  2. Section of Endocrinology and Metabolism, Marmara University School of Medicine, Fevzi Cakmak Mah. Muhsin Yazicioglu Cad. No: 10 Pendik, 34899, Istanbul, Turkey

    D. Gogas Yavuz & M. Uygur

Authors
  1. H. Alibas
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  2. D. Gogas Yavuz
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  3. P. Kahraman Koytak
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  4. M. Uygur
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  5. T. Tanridag
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  6. K. Uluc
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Corresponding author

Correspondence to H. Alibas.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the local ethics committee. The study was carried out in accordance with the Declaration of Helsinki and supported by Marmara University Research Foundation (SAG-C TUP-120613-0245).

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All subjects gave informed consent for participation.

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Alibas, H., Gogas Yavuz, D., Kahraman Koytak, P. et al. Peripheral nervous system assessment in acromegaly patients under somatostatin analogue therapy. J Endocrinol Invest 40, 33–40 (2017). https://doi.org/10.1007/s40618-016-0522-9

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  • DOI: https://doi.org/10.1007/s40618-016-0522-9

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