title: The characteristics of acromegalic patients with hyperprolactinemia and the differences in patients with merely GH-secreting adenomas: clinical analysis of 279 cases.
abstract: OBJECTIVE
  The aim of this study is to evaluate clinical data from a large cohort of acromegalic patients with and without hyperprolactinemia.
  
  
  METHODS
  Between January 2002 and June 2010, a set of data on 279 acromegalic patients undergoing transsphenoidal surgery was available. Based on preoperative GH and prolactin (PRL) levels, patients were divided into GH and GH+PRL groups. A stabilization or a further improvement of postoperative changes in clinical, hormonal, immunohistochemical, and magnetic resonance imaging parameters was observed in all patients throughout the follow-up period.
  
  
  RESULTS
  The GH group had significantly more coarse facial features, large hands and feet, hypertension, and diabetes mellitus compared with the GH+PRL group but significantly less menstrual disorders (13.8 vs 54.3%, P<0.001) and galactorrhea (3.1 vs 22.4%, P<0.001). The GH group had a higher age at diagnosis compared with the GH+PRL group (45.6 ± 13.9 vs 40.4 ± 11.4 years, P=0.001). The GH group had a smaller mean maximal diameter of the adenomas (2.2 ± 0.9 vs 2.6 ± 1.1 cm, P=0.004). There were no significant correlations between hormone levels and the immunohistochemical results. According to the criteria for hormonal cure of acromegaly, the surgical control rates in the GH and GH+PRL groups were 68.4 and 59.7% respectively (P=0.187). Tumor size was an important factor that affected the results of the operations. The rates of surgical control in GH and GH+PRL groups were 80.7 and 69.1% respectively (P=0.037), and the recurrence rates in the two groups were 7.1 and 11.3% respectively (P=0.185).
  
  
  CONCLUSIONS
  Compared with patients with merely GH-secreting adenomas, acromegalic patients with hyperprolactinemia are characterized by an earlier onset of disease, lesser acromegalic features, lower GH levels, but larger tumor sizes, whereas in female patients, GH-PRL secreting adenomas are associated with higher incidences of menstrual disorders and galactorrhea.
authors.affiliation: Department of Neurosurgery, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, Shandong 250021, People's Republic of China. head120@hotmail.com
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.forename: Chengzhi
authors.initials: C
authors.lastname: Mou
authors.forename: Meng
authors.initials: M
authors.lastname: Jiang
authors.forename: Lizhang
authors.initials: L
authors.lastname: Han
authors.forename: Shengqiang
authors.initials: S
authors.lastname: Fan
authors.forename: Cheng
authors.initials: C
authors.lastname: Huan
authors.forename: Xin
authors.initials: X
authors.lastname: Qu
authors.forename: Tao
authors.initials: T
authors.lastname: Han
authors.forename: Yuanming
authors.initials: Y
authors.lastname: Qu
authors.forename: Guangming
authors.initials: G
authors.lastname: Xu
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D000236:Adenoma / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D011388:Prolactin