Risk of colorectal neoplasm in patients with acromegaly and its relationship with serum growth hormone levels.
OBJECTIVE
Acromegalics have been reported to be at an increased risk of colorectal neoplasm. However, the magnitude of the risk is still controversial and the mechanism has not been fully investigated. In this study, we attempted to determine the magnitude of the association between acromegaly and colorectal lesions after taking into account age, gender, smoking status, and treatment status. In addition, we assessed the relationship between colorectal lesions and serum growth hormone (GH) levels in acromegalics.


METHODS
We conducted a case-control study by using 19 consecutive untreated patients (male:female = 11:8) who were newly diagnosed with acromegaly between 1990 and 2000. All patients underwent colonoscopy and received a histological diagnosis of colorectal lesions. Prevalence of hyperplastic polyp, adenoma, and carcinoma were compared with the prevalence in 76 controls matched for gender, age, and smoking status. Serum GH levels were compared between acromegalic patients with and without each type of colorectal lesion.


RESULTS
The prevalence of hyperplastic polyp, adenoma, and carcinoma were significantly higher in the acromegalic patients compared to the controls (p < 0.05, odds ratios; 8.3, 4.2, and 9.8, respectively). In acromegalics, the presence of hyperplastic polyps and carcinomas were significantly associated with higher serum GH levels after adjusting for the other lesions and age (p < 0.05).


CONCLUSIONS
After controlling for age, gender, smoking status, and treatment status, acromegaly was associated with significantly higher prevalence of colorectal hyperplastic polyp, adenoma, and carcinoma. High serum GH levels may be associated with the presence of hyperplastic polyp and carcinoma.
Matano
Yutaka
Y
The Second Department of Internal Medicine, Kanazawa University School of Medicine, Ishikawa, Japan.
Okada
Toshihide
T
Suzuki
Ayako
A
Yoneda
Takashi
T
Takeda
Yoshiyun
Y
Mabuchi
Hiroshi
H
D000172:Acromegaly / Q000097:blood / Q000150:complications*; D000236:Adenoma / Q000097:blood / Q000150:complications; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000097:blood / Q000150:complications; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000097:blood / Q000150:complications*; D003111:Colonic Polyps / Q000097:blood / Q000150:complications; D003113:Colonoscopy; D005260:Female; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D006965:Hyperplasia; D007417:Intestinal Polyps / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000097:blood / Q000150:complications*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking
D019382:Human Growth Hormone