Polycystic ovaries and the polycystic ovary syndrome phenotype in women with active acromegaly.
BACKGROUND
Previous retrospective studies have suggested that women with acromegaly may present with menstrual irregularity and symptoms/signs of hyperandogenism, a phenotype similar to that of the polycystic ovary syndrome (PCOS).


OBJECTIVE
The aim of this study was to investigate prospectively the presence of the PCOS phenotype (PCOSP) and polycystic ovaries (PCO) on ultrasonography in women with active acromegaly.


METHODS
Women within the reproductive age range (21-43 years) with active acromegaly of recent onset and/or previous surgical and/or medical therapy were studied.


METHODS
Subjects underwent a physical examination; fasting bloods for androgens, pituitary hormones and metabolic parameters; an oral glucose tolerance test (OGTT) to estimate disease activity and insulin resistance; and a transvaginal ultrasound.


RESULTS
Six women had newly diagnosed acromegaly, and eight still had active disease following previous surgical and/or medical treatment. Seven women were found to have PCO and six fulfilled the criteria for PCOSP; six of these women, five with PCOSP, had a pituitary macroadenoma. Women with PCOSP had significantly increased mean ovarian volumes and characteristic ovarian morphology compared to women without PCOSP (P < 0.05), higher levels of IGF-1 and testosterone and lower SHBG levels that did not reach statistical significance. A positive correlation between IGF-1 and mean ovarian volume was identified only in women with PCOSP (r = 0.851, P < 0.05).


CONCLUSIONS
PCO and PCOSP are relatively common in women with acromegaly and may account for some of the symptoms related to gonadal dysfunction irrespective of the size of the pituitary tumour. It is likely that IGF-1 alone or in combination with GH and/or insulin resistance may be involved.
Kaltsas
Gregory A
GA
Endocrine Unit, Department of Pathophysiology, University of Athens, Athens, Greece. gkaltsas@endo.gr
Androulakis
Ioannis I
II
Tziveriotis
Kostas
K
Papadogias
Dimitrios
D
Tsikini
Aggeliki
A
Makras
Polysois
P
Dimitriou
Konstantina
K
Stathopoulou
Alexandra
A
Piaditis
George
G
D000172:Acromegaly / Q000097:blood / Q000453:epidemiology*; D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000473:pathology; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000453:epidemiology*; D055815:Young Adult
D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone