Elbaum Michał, Kałużny Marcin, Jawiarczyk-Przybyłowska Aleksandra, Wojtczak Beata, Zieliński Grzegorz, Bolanowski Marek
Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże L. Pasteura 4, 50-367 Wroclaw, Poland.
Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Str. 213, 50-556 Wroclaw, Poland.
J Clin Med. 2023 Sep 30;12(19):6309. doi: 10.3390/jcm12196309.
Uncontrolled acromegaly causes increased morbidity and mortality. The analysis of acromegaly comorbidities and complications is important when establishing a standard of care for the entire population of acromegaly patients. The aim of this study was to determine the frequency of comorbidities and complications of acromegaly and their dependence on the activity of the disease. A retrospective analysis of medical records from 124 patients with acromegaly was carried out, including 39 who were cured, 73 treated with somatostatin analogs and 12 newly diagnosed patients. The incidence of comorbidities and complications was very high, and those most frequently observed were arterial hypertension, multinodular goiter, lipid disorders, hypopituitarism and degenerative changes. At least one complication of acromegaly was observed in 92% of patients undergoing successful neurosurgery and in all pharmacologically treated patients. By contrast, two or more complications were observed in 77% of cured patients and in pharmacologically controlled and uncontrolled patients, 82% and 91%, respectively. Conclusions: Acromegaly is associated with a high prevalence of complications. Active acromegaly is associated with a higher incidence of complications than in treated groups. Untreated patients have more complications than treated patients. Successfully cured patients have significantly fewer complications than pharmacologically controlled patients and patients with active acromegaly.
未控制的肢端肥大症会导致发病率和死亡率增加。在为全体肢端肥大症患者制定护理标准时，分析肢端肥大症的合并症和并发症很重要。本研究的目的是确定肢端肥大症合并症和并发症的发生率及其与疾病活动度的相关性。对124例肢端肥大症患者的病历进行了回顾性分析，其中包括39例已治愈患者、73例接受生长抑素类似物治疗的患者和12例新诊断患者。合并症和并发症的发生率非常高，最常观察到的是动脉高血压、多结节性甲状腺肿、脂质紊乱、垂体功能减退和退行性改变。在接受成功神经外科手术的患者中，92%观察到至少一种肢端肥大症并发症，在所有接受药物治疗的患者中也均有观察到。相比之下，在已治愈患者中，77%观察到两种或更多并发症，在药物控制和未控制的患者中，这一比例分别为82%和91%。结论：肢端肥大症与高并发症发生率相关。与治疗组相比，活动期肢端肥大症的并发症发生率更高。未治疗患者比治疗患者有更多并发症。成功治愈的患者比药物控制的患者和活动期肢端肥大症患者的并发症明显更少。
