Department of Endocrinology, Translational Research Key Laboratory for Diabetes, The Second Affiliated Hospital (Xinqiao Hospital), Army Medical University, Chongqing, China.
Department of Endocrinology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Exp Clin Endocrinol Diabetes. 2022 Nov;130(11):714-722. doi: 10.1055/a-1913-7900. Epub 2022 Sep 8.
To investigate the clinical characteristics and associated factors of colonic polyps in patients with acromegaly.
Clinical characteristics and colonoscopy findings of 86 acromegaly patients who received treatment were retrospectively reviewed, and colonoscopy findings and the correlation with growth hormone (GH)-secreting pituitary adenoma (GHPA) volume and hormonal/metabolic levels were analyzed.
The prevalence of colonic polyps in acromegaly patients was 40.7% and increased significantly with advanced age, especially in those ≥50 years. Multiple polyps (62.8%) and colonic polyps in the left colon (54.2%) were detected more frequently. Compared to acromegaly patients without polyps, those with polyps displayed higher insulin-like growth factor-1 × upper limit of normal (IGF-1×ULN) levels (=0.03). IGF-1 levels and GHPA volumes in patients with polyps showed increasing trends, although the differences were not significant. GH levels were higher in patients with polyps of diameter ≤5 mm than those with polyps of diameter >5 mm (=0.031). The univariate and multivariate logistic regression analysis revealed that GHPA volumes (OR: 1.09, 95% CI: 1.01-1.20; =0.039) and IGF-1×ULN Q2 levels (OR: 6.51, 95% CI: 1.20-44.60; =0.038) were independent factors for predicting the risk of colonic polyp occurrence in acromegaly patients. A nomogram was prepared to evaluate the risk of colonic polyps in acromegaly patients.
The acromegalic patients are a population with a high prevalence of colonic polyps. GHPA volumes and IGF-1×ULN levels may be predictors of colonic polyp occurrence.
研究肢端肥大症患者结肠息肉的临床特征及相关因素。
回顾性分析 86 例接受治疗的肢端肥大症患者的临床特征和结肠镜检查结果，分析结肠镜检查结果与生长激素（GH）分泌性垂体腺瘤（GHPA）体积及激素/代谢水平的相关性。
肢端肥大症患者结肠息肉的患病率为 40.7%，随着年龄的增长而显著升高，尤其是≥50 岁的患者。多发息肉（62.8%）和左半结肠息肉（54.2%）更为常见。与无息肉的肢端肥大症患者相比，有息肉的患者 IGF-1×正常值上限（IGF-1×ULN）水平更高（=0.03）。有息肉患者的 IGF-1 水平和 GHPA 体积呈上升趋势，但差异无统计学意义。与直径>5mm 的息肉患者相比，直径≤5mm 的息肉患者 GH 水平更高（=0.031）。单因素和多因素 logistic 回归分析显示，GHPA 体积（OR：1.09，95%CI：1.01-1.20；=0.039）和 IGF-1×ULN Q2 水平（OR：6.51，95%CI：1.20-44.60；=0.038）是肢端肥大症患者发生结肠息肉的独立预测因素。建立了一个列线图来评估肢端肥大症患者发生结肠息肉的风险。
肢端肥大症患者是结肠息肉高发人群。GHPA 体积和 IGF-1×ULN 水平可能是结肠息肉发生的预测因素。
