Alzajaji Qusay Baqer, Alidrisi Haider A, Mansour Abbas A
Diabetes and Endocrinology, Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah, IRQ.
Internal Medicine, University of Basrah, Basrah, IRQ.
Cureus. 2021 Nov 10;13(11):e19438. doi: 10.7759/cureus.19438. eCollection 2021 Nov.
Background Acromegaly is a disabling disease caused by growth hormone (GH) over-secretion, associated with increased morbidity and mortality through different metabolic and somatic consequences involving soft tissue, acral overgrowth, and skin thickening, which will lead to different clinical manifestations. The study aimed to assess the correlation between biochemical markers of acromegaly with different clinical findings and biochemical control with the clinical findings. Methods A cross-sectional study was done on 56 patients with acromegaly attending a tertiary center for diabetes, endocrine, and metabolism in Southern Iraq Basrah. They were 32 (57.1%) males. Fatigue, headache, excessive sweating, joint pain, backache, soft tissue swelling, numbness, snoring, and visual problems were assessed on a four-point Likert scale. In addition, biochemical dynamic GH testing was done using a five-point random GH curve and/or standard GH suppression under the oral glucose tolerance test (OGTT). Results No significant correlation was found between symptoms severity and five-point GH parameters in respect of mean, peak, and nadir. Only backache showed a significant correlation with GH under OGTT suppression parameters in respect to mean, peak, and nadir (P-values < 0.01, < 0.01, and < 0.01), respectively. No particular biochemical control cut-off value in the 9 am random GH, mean five-point GH curve, or nadir GH under OGTT was correlated with the degree of severity for any of the clinical symptoms, as there was no difference between the biochemically controlled and uncontrolled groups in respect to any of the clinical symptom's severity scale. Conclusion Only backache correlated with the biochemical tests of disease activity in the form of GH under OGTT. It appears in this study that the severity of the clinical symptoms does not correlate with biochemical control so that thorough evaluation and treatment of clinical complaints besides biochemical control is an essential part of the management plan in patients with acromegaly.
肢端肥大症是一种由生长激素（GH）分泌过多引起的致残性疾病，通过涉及软组织、肢端过度生长和皮肤增厚的不同代谢和躯体后果，导致发病率和死亡率增加，进而引发不同的临床表现。本研究旨在评估肢端肥大症的生化标志物与不同临床发现之间的相关性，以及生化控制与临床发现之间的相关性。
对伊拉克南部巴士拉一家糖尿病、内分泌和代谢三级中心的56例肢端肥大症患者进行了横断面研究。其中男性32例（57.1%）。采用四点李克特量表评估疲劳、头痛、多汗、关节痛、背痛、软组织肿胀、麻木、打鼾和视觉问题。此外，使用五点随机GH曲线和/或口服葡萄糖耐量试验（OGTT）下的标准GH抑制进行生化动态GH检测。
在均值、峰值和最低点方面，症状严重程度与五点GH参数之间未发现显著相关性。仅背痛在OGTT抑制参数的均值、峰值和最低点方面与GH显示出显著相关性（P值分别<0.01、<0.01和<0.01）。在上午9点随机GH、平均五点GH曲线或OGTT下的最低点GH中，没有特定的生化控制临界值与任何临床症状的严重程度相关，因为在任何临床症状严重程度量表方面，生化控制组和未控制组之间没有差异。
仅背痛与OGTT下以GH形式的疾病活动生化测试相关。在本研究中，临床症状的严重程度似乎与生化控制无关，因此除了生化控制外，对临床症状进行全面评估和治疗是肢端肥大症患者管理计划的重要组成部分。
