title: Early lung function abnormalities in acromegaly.
abstract: BACKGROUND
  Acromegaly is an insidious disorder caused by a pituitary growth hormone (GH)-secreting adenoma resulting in high circulating levels of GH and insulin-like growth factor I (IGF-I). Respiratory disorders are common complications in acromegaly, and can severely impact on quality of life, eventually affecting mortality.
  
  
  OBJECTIVE
  The present study aimed to explore structural and functional lung alterations of acromegalic subjects.
  
  
  METHODS
  We enrolled 10 consecutive patients (M/F: 5/5) affected by acromegaly. In all patients, magnetic resonance imaging (MRI) revealed the presence of pituitary tumor. All patients underwent clinical, lung functional, biological, and radiological assessments. Ten healthy age-matched subjects also served as controls.
  
  
  RESULTS
  No statistically significant differences in lung function were detected between acromegalic and healthy subjects (p ≥ 0.05 for all analyses). However, the diffusing capacity for CO (TLCO) was significantly lower in the acromegalic group than in healthy subjects (TLCO% predicted: 78.1 ± 16 vs. 90 ± 6 %, respectively, p = 0.04; KCO% predicted: 77 ± 16 vs. 93 ± 5 %, p = 0.02, respectively). None of the lung function parameters correlated with duration of the disease, or with inflammatory marker of the airways. In acromegalics, biological (exhaled NO concentrations) and imaging (total lung volume, TLV, and mean lung density, MLD) evaluations were within normal values. The TLV measured by HRCT was 3540 ± 1555 ml in acromegalics, and the MLD was -711 ± 73 HU. None of the lung functional, radiological, and biological findings correlated with GH or IGF-I levels, and no correlation was found with duration of disease.
  
  
  CONCLUSIONS
  In the current study, lung function evaluation allowed to detect early involvement of lung parenchyma, as assessed by TLCO and KCO, even in the absence of parenchymal density alterations of the lung by HRCT. These findings suggest to routinely include the carbon monoxide diffusing capacity in the lung function assessment for an early intervention in acromegaly.
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Pneumologia, Università degli Studi di Palermo, via Trabucco 180, 90146, Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Benfante
authors.forename: A
authors.initials: A
authors.lastname: Ciresi
authors.forename: M
authors.initials: M
authors.lastname: Bellia
authors.forename: F
authors.initials: F
authors.lastname: Cannizzaro
authors.forename: V
authors.initials: V
authors.lastname: Bellia
authors.forename: C
authors.initials: C
authors.lastname: Giordano
authors.forename: N
authors.initials: N
authors.lastname: Scichilone
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D042241:Early Diagnosis; D005260:Female; D005541:Forced Expiratory Volume; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008176:Lung Volume Measurements; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011653:Pulmonary Diffusing Capacity; D011859:Radiography; D013997:Time Factors; D014797:Vital Capacity