Thyroid Dysfunction in Iraqi Patients with Acromegaly

Abstract

Acromegaly is a chronic endocrine disorder caused by hypersecretion of growth hormone (GH) mostly because of pituitary adenoma. GH induces the formation of Insulin like Growth Factor1 (IGF1)from the liver. Both GH andIGF1 lead to sign and symptom of acromegaly.
Aim: This study designed to identify the prevalence of thyroid dysfunction in Iraqi patients with acromegaly ,to identify the factors responsible for thyroid dysfunction in patients with acromegaly.Is the treatment modalities for acromegaly has a role in thyroid dysfunction?
Study design: A cross sectional case control study
Patients and Method: seventy patients with acromegaly were enrolled from 2 different tertiary centers of endocrinology from Jan. -Dec. 2017 compared with 70 non acromeglic subjects. Their mean age 46 +/-11 years ;forty one (58.5%) males and 29(41.5%)females. Thyroid function test conducted to both patients and control groups including TSH, free T4 and total T3 in both centers. In addition to other variables.
Results: Out of 70 (100%) patients with acromegaly; (51.5%) were euthyroid, (20%) had primary hypothyroidism , (15.7%)had central hypothyroidism and (12.8%) had hyperthyroidism that is significantly higher than normal population (p<0.001).Patient with acromegaly had significant systolic and diastolic hypertension vs. control (p=0.015 ,0.004 respectively).Age of the patients, diastolic blood pressure ,first GH and history of hypophysectomy were significant risk factors for thyroid dysfunction (p=0.02,0.008,0.008 and 0.02 respectively)
Conclusion : Thyroid dysfunction is more prevalent in patient with acromegaly whether hypothyroidism (both primary and secondary) and hyperthyroidism. The Age and diastolic blood pressure are independent risk factors of thyroid dysfunction. There is significant role of hypophysectomy in thyroid dysfunction development while Sandostatin (Octreotide LAR) treatment had no role.