Abreu Lomba Alin, Corredor-Rengifo David, Mejia Velez Cesar Augusto, Carvajal Ortiz Reynaldo, Pantoja Guerrero Doly, Arenas Henry Mauricio, Castellanos Pinedo Alejandro Alberto, Morales Garcia Monica Andrea, Pinzon Tovar Alejandro, Vernaza Trujillo David Alexander, Sierra Castillo Santiago
Endocrinology, Imbanaco Clinic, Cali, COL.
Internal Medicine, Universidad Libre, Cali, COL.
Cureus. 2024 Dec 11;16(12):e75553. doi: 10.7759/cureus.75553. eCollection 2024 Dec.
Acromegaly, although rare, is associated with multiple manifestations and complications; its high morbidity and mortality makes it a challenge. Treatment involves surgery and pharmacological therapies, focusing on biochemical normalization. This study analyzes the biochemical control in Colombian patients with acromegaly, seeking to improve the understanding of the effects of treatments in the management of the disease.
A multicenter retrospective cohort study was conducted with data from a national acromegaly registry in Colombia (2017-2023), analyzing the biochemical control for 12 months according to the treatment modalities received.
A total of 117 patients were analyzed, with 54 individuals from Valle del Cauca and 63 being women, representing different population groups in Colombia. The median age was 52 years, and the median disease duration was six years. Clinically, arterial hypertension and sleep apnea were observed in 53.8% (n = 63) and 45.3% (n = 53) of the cohort, respectively. Biomarker analysis revealed elevated levels of insulin-like growth factor-1 (IGF-1) and growth hormone (GH). The majority of tumors were macroadenomas, and among the 103 surgically removed tumors, all secreted GH. Of these, 58.3% (n = 60) had GH as the sole marker, while 12.6% (n = 13) co-expressed prolactin (PRL). At first, 92.3% (n = 108) of patients had no biochemical control. At six and 12 months, 34.1% (n = 40) and 21.2% (n = 25) achieved biochemical control, respectively. The reduction in tumor size was significant during follow-up, with a median size at the month of admission of 16 mm, with a reduction >20% at month 12 in 92.3% (n = 108) of patients.
In Colombian patients with acromegaly, biochemical control at 12 months is lower than that reported in the literature, suggesting that pharmacological management could be associated with greater biochemical control.
肢端肥大症虽然罕见，但与多种表现和并发症相关；其高发病率和死亡率使其成为一项挑战。治疗包括手术和药物治疗，重点是生化指标正常化。本研究分析了哥伦比亚肢端肥大症患者的生化控制情况，旨在增进对治疗在该疾病管理中效果的理解。
利用哥伦比亚全国肢端肥大症登记处（2017 - 2023年）的数据进行了一项多中心回顾性队列研究，根据所接受的治疗方式分析了12个月的生化控制情况。
共分析了117例患者，其中来自考卡山谷的有54例，女性63例，代表了哥伦比亚不同的人群组。中位年龄为52岁，中位病程为6年。临床上，分别有53.8%（n = 63）和45.3%（n = 53）的队列患者观察到动脉高血压和睡眠呼吸暂停。生物标志物分析显示胰岛素样生长因子-1（IGF-1）和生长激素（GH）水平升高。大多数肿瘤为大腺瘤，在103例手术切除的肿瘤中，所有肿瘤均分泌GH。其中，58.3%（n = 60）以GH作为唯一标志物，而12.6%（n = 13）共表达催乳素（PRL）。起初，92.3%（n = 108）的患者没有生化控制。在6个月和12个月时，分别有34.1%（n = 40）和21.2%（n = 25）实现了生化控制。随访期间肿瘤大小显著减小，入院时的中位大小为16毫米，92.3%（n = 108）的患者在第12个月时减小超过20%。
在哥伦比亚肢端肥大症患者中，12个月时的生化控制低于文献报道，这表明药物管理可能与更好的生化控制相关。
