Acromegaly in Iraq: Brief Look on Epidemiology, Comorbidities and Management
AbstractObjective: Acromegaly is a rare chronic condition in adults resulted from continuous over secretion of growth hormone (GH) and hence increased production of insulin-like growth factor-1 (IGF-1). Pituitary adenoma is the underlying cause in vast majority of cases. This study aims to evaluate clinico-epidemiological characteristics for a group of Iraqi individuals with this disease.
Method: Case notes and files of 60 acromegalic patients attending Iraqi National Diabetes Center were reviewed during period of October through December 2017. To be included, the diagnosis of acromegaly should be confirmed by appropriate laboratory and imagining techniques. Disease control and biochemical response to management was defined by the criteria of normalized IGF-1 for age and sex (Z-score ≤ 2) and a mean GH value ≤ 2 μg/l. Data was entered and analyzed using SPSS program, version 20. Descriptive statistics was used; presented as frequencies and proportions, or means and standard deviations according to variable type.
Results: Patients were almost equally distributed among both sexes. Their mean age is 50.6 ± 11.7 years. Time interval between symptoms' onset and diagnosis was nearly 10 years. Macroadenoma (> 1cm) was found in 47 (78.3%) patients. Diabetes mellitus and hypertension affected 42 (70.0%) and 37 (61.7%) individuals, respectively. For disease control, all acromegalics were put on long-acting somatostatin analogue and 21 (35.0%) of them performed hypophysectomy. In 45 (75.0%) patients, growth hormone value was dropped to ≤2 mg/l; and in 41 (68.3%), IGF-1 was normalized for age and sex.
Conclusion: The clinco-epidemiological characteristics of acromegaly in Iraq are comparable to that reported in other countries, although there is some delay in time of diagnosis. Associated comorbidities (diabetes and hypertension) affected large number of patients. Good proportion of study sample, nearly two-thirds, showed good metabolic response to treatment.
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