Adrenal morphology and function in acromegalic patients in relation to disease activity.
Visceromegaly is a common consequence of acromegaly. However, few studies investigated the chronic effects of growth hormone on adrenal glands. Our aim was to evaluate adrenal morphology and function in a cohort of acromegalic patients in relation to disease activity. Twenty-six acromegalics (10 males and 16 females) and 21 healthy subjects were investigated. Gland morphology was evaluated by computerized axial tomography, measuring central, lateral, and medial adrenal segments. Uncontrolled acromegalics showed increased volume of all adrenal segments, higher urinary free cortisol (UFC), and lower morning adrenocorticotropic hormone in comparison with healthy subjects. However, normal cortisol levels after low-dose dexamethasone suppression test indicated a preserved regulation of the hypothalamic-pituitary-adrenal axis. In addition, uncontrolled patients showed greater medial segment of right gland, higher UFC, and aldosterone levels with respect to controlled patients. All acromegalics did not show any difference in adrenal size when grouped according to UFC/24 h levels. In addition, no difference was found in any of the parameters between normotensive and hypertensive patients. In conclusion, our findings confirm that acromegaly affects adrenal size as well as other organs. In addition, we report a stimulatory effect of growth hormone on adrenal function, although the regulation of the hypothalamic-pituitary-adrenal axis is preserved.
Ciresi
Alessandro
A
Section of Endocrinology, DOSAC (Dipartimento di Oncologia Sperimentale ed Applicazioni Cliniche), University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy.
Amato
Marco C
MC
Vetro
Calogero
C
Lo Coco
Renato
R
Galluzzo
Aldo
A
Giordano
Carla
C
D000172:Acromegaly / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D000311:Adrenal Glands / Q000473:pathology* / Q000502:physiology*; D000328:Adult; D000368:Aged; D002319:Cardiovascular System / Q000503:physiopathology; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010913:Pituitary-Adrenal System / Q000502:physiology; D012720:Severity of Illness Index
Clin Endocrinol (Oxf). 1989 Oct;31(4):431-8
2534066
Diabetes Care. 1997 Jul;20(7):1183-97
9203460
Clin Endocrinol (Oxf). 2001 Feb;54(2):137-54
11207626
Circulation. 1978 Dec;58(6):1072-83
709763
Arch Intern Med. 1974 Sep;134(3):415-7
4855393
J Endocrinol. 1998 Sep;158(3):409-17
9846170
Diabetologia. 1985 Jul;28(7):412-9
3899825
Endocr Pract. 2002 Jan-Feb;8(1):54-60
11939762
Endocr Res. 1999 Aug-Nov;25(3-4):281-93
10596723
Clin Endocrinol (Oxf). 1981 Jun;14(6):605-12
7296906
J Clin Endocrinol Metab. 1979 May;48(5):784-9
372207
Eur J Clin Pharmacol. 1990;38(5):409-13
2143136
Q J Med. 1990 Aug;76(280):855-67
2217688
Horm Res. 1984;19(3):185-90
6325319
J Hypertens. 2003 Jun;21(6):1011-53
12777938
J Endocrinol Invest. 2008 Jul;31(7):602-6
18787376
Am J Surg. 2001 Aug;182(2):185-7
11574094
J Clin Endocrinol Metab. 1975 Sep;41(3):542-5
1159061
J Endocrinol Invest. 2002 Mar;25(3):240-5
11936466
J Clin Endocrinol Metab. 2000 Feb;85(2):526-9
10690849