METABOLIC SYNDROME AND THYROID DYSFUNCTION IN PATIENTS WITH ACROMEGALY IN SULAIMANI

Abstract

Background  Acromegaly is a chronic endocrinology disorder caused by the over-production of growth hormone (GH) predominantly by a pituitary adenoma. Acromegaly is associated with metabolic changes and thyroid dysfunction (ThD) in the body. However, the frequency of metabolic syndrome (MtS) in acromegaly patients is unknown, and studies assessing the frequency of different ThD types in acromegaly cases were few. Objectives  To analyze the frequencies of MtS and ThD in patients with acromegaly in comparison to controls in Sulaimani city, to find the frequencies of MtS and ThDs in active cases compared to inactive cases in acromegaly patients, and to assess the relationship between the cumulative exposure to Insulin-like Growth Factor 1 (IGF-1) with ThD and MtS in acromegaly. Patients and Methods In this case-control study, 82 subjects were enrolled, which included 22 patients with acromegaly who visited the Sulaimani endocrinology center from August 2021 to February 2022 and 60 control subjects. The mean age of cases was 47.55 [11.50] years, with 7 (31.8%) male and 15 (68.2%) female. Thyroid function test, clinical, and biochemical parameters of MtS were measured in both groups in addition to IGF1. Chi-square test, Student T-test, and ANOVA were used in data analysis. Correlation between quantitative variables determined by Pearson correlation, with a P-value ≤ 0.05, is significant Results Out of 22 patients with acromegaly, 68.2% were euthyroid, 9.1% had primary hypothyroidism, 18.2% had central hypothyroidism, and 4.5% had hyperthyroidism, which is significantly higher than the control group (p-value =0.002). MtS frequency is 68.18% in cases, significantly higher than control, p-value=0.011. Most MtS and ThD parameters were significantly higher in acromegaly patients than in controls, P-value < 0.001. No significant correlation between the last IGF1 and other parameters existed except free T3, which has a significant negative correlation with IGF1, P < 0.05.  Conclusion In acromegaly, the frequency of MtS is high (68.18%), and the frequency of ThD is 31.8%. Both MtS and ThDs are more common in patients compared to controls. No significant relationship exists between disease activity and the presence of MtS or ThD. Because both MtS and ThDs increase the metabolic markers, consequently increasing cardiovascular disease (CVD) morbidity and mortality in cases.