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Ságová I, Kantárová D, Mokáň M, Vaňuga P. Changes in Cross-Sectional Area of the Median Nerve and Body Composition Parameters after Treatment of Acromegaly: 1 year Follow-Up. Int J Endocrinol 2022; 2022:8766046. [PMID: 36277124 PMCID: PMC9584700 DOI: 10.1155/2022/8766046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Median neuropathy is a common manifestation of acromegaly, although its pathology is uncertain. Changes in levels of growth hormone (GH) and insulin-like growth factor I (IGF-I) and body composition are potential parameters in pathology of median neuropathy in acromegaly. We aimed to assess changes in the cross-sectional area (CSA) of the median nerve and body composition in newly diagnosed acromegalic patients 1 year after treatment and to determine their mutual relationships. DESIGN This prospective study included 30 patients with newly diagnosed acromegaly and 30 healthy controls matched for age, gender, and body mass index. Physical and laboratory examinations, dual-energy X-ray absorptiometry (DXA), and ultrasound evaluations were performed at baseline and 1 year after initial treatment. RESULTS The CSA of the median nerve was increased in acromegalic patients compared with controls (13.1 mm2 [12.2-14.9] vs 7.5 mm2 [6.4-8.4], P < 0.001). One year after treatment of acromegaly, GH and IGF-I levels decreased significantly. The median nerve CSA was significantly reduced after treatment (11.6 mm2 [10.2-13.1], P < 0.001). Reduction of IGF-I levels correlated with a decrease in lean mass and increase in fat mass. The median nerve CSA positively correlated with IGF-I levels (R = 0.492, P=0.006) and lean mass (R = 0.419, P=0.021) in acromegalic patients before treatment. CONCLUSION This study demonstrates a reduction in the median nerve CSA 1 year after treatment of acromegaly. These changes are closely associated with a reduction in IGF- I levels and in lean body mass. The enlargement of the median nerve in acromegaly can be reversed with adequate treatment.
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Affiliation(s)
- Ivana Ságová
- Department of Endocrinology, National Institute of Endocrinology and Diabetology, Ľubochňa, Slovakia
- Comenius University Jessenius Faculty of Medicine, 1st Department of Internal Medicine, University Hospital Martin, Martin, Slovakia
| | - Daniela Kantárová
- Comenius University Jessenius Faculty of Medicine, 1st Department of Internal Medicine, University Hospital Martin, Martin, Slovakia
| | - Marián Mokáň
- Comenius University Jessenius Faculty of Medicine, 1st Department of Internal Medicine, University Hospital Martin, Martin, Slovakia
| | - Peter Vaňuga
- Department of Endocrinology, National Institute of Endocrinology and Diabetology, Ľubochňa, Slovakia
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Papier K, Knuppel A, Perez-Cornago A, Watts EL, Tong TYN, Schmidt JA, Allen N, Key TJ, Travis RC. Circulating insulin-like growth factor-I and risk of 25 common conditions: outcome-wide analyses in the UK Biobank study. Eur J Epidemiol 2022; 37:25-34. [PMID: 34746972 PMCID: PMC8791904 DOI: 10.1007/s10654-021-00811-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022]
Abstract
While there is strong epidemiological evidence that circulating insulin-like growth factor-I (IGF-I) is associated with a higher risk of several cancers, little is known about its association with non-cancer outcomes. We investigated associations of circulating IGF-I with risk of 25 common conditions, other than cancer, in a large British cohort. Study participants were 318,749 middle-aged adults enrolled in the UK Biobank Study. Serum IGF-I concentration was measured in samples collected at baseline (2006-2010), and re-measured in 12,334 participants after an average of 4.3 years. We followed-up participants over an average of 11.5 years by linking to hospital admissions and mortality registries. Multivariable-adjusted Cox regressions estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between circulating IGF-I and 25 common conditions, using the repeated IGF-I measurements to correct for regression dilution bias. After correction for multiple testing (P < 0.002), IGF-I was positively associated with carpal tunnel syndrome (HR per 5 nmol/l higher concentration = 1.12, 95% CI 1.08-1.16), and inversely associated with varicose veins (0.90, 0.85-0.95), cataracts (0.97, 0.95-0.99), diabetes (0.92, 0.90-0.95), and iron deficiency anaemia (0.90, 0.86-0.93). The associations for cataracts and diabetes attenuated when restricted to cases diagnosed after five or more years of follow-up, suggesting that these associations were likely affected by reverse causality. Higher IGF-I concentration might be associated with the risk for several conditions, but genetic studies are needed to clarify which associations may be causal.
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Affiliation(s)
- Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK.
| | - Anika Knuppel
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Eleanor L Watts
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Naomi Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
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Ságová I, Pavai D, Kantárová D, Holováčová D, Kužma M, Payer J, Vaňuga P. Influence of Disease Activity and Body Composition Parameters on Cross-Sectional Area of the Median Nerve in Acromegalic Patients. Physiol Res 2021. [DOI: 10.33549//physiolres.934681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Carpal tunnel syndrome (CTS) is neuropathy that occurs due to compression of the median nerve in the carpal tunnel. Acromegaly is one of the important causes of CTS. The aim of this study was to examine median nerve with ultrasound in acromegalic patients and to assess the relationship with activity, duration of disease and body composition parameters. We prospectively examined the cross-sectional area (CSA) of the median nerve with high-resolution ultrasound in 107 acromegalic patients – control group (70 females and 37 males) and 107 healthy controls (70 females and 37 males) matched for age, gender, and BMI. Body composition parameters were assessed by dual-energy X-ray absorptiometry (DXA). The Student t-tests and Pearson correlation were used for data analysis. The cross sectional area of the median nerve was increased in acromegalic patients compared to controls (11.9±4.8 mm2 vs. 7.7±2.4 mm2, P<0.001). Positive correlation was found between IGF-1 levels and CSA in the acromegalic group (R = 0.400, P<0.001). Relationship between CSA and duration of acromegaly was not confirmed. In acromegalic patients, BMI correlated with the CSA (R=0.294, P=0.002). There was no significant difference in BMI, fat mass between the acromegalic and control group, but lean mass was higher in acromegalic patients compared with controls (54.8±13.3 vs. 51±11.6, P=0.047). Lean mass and LMI (total body lean mass/height) positively correlated with CSA in acromegalic patients (R=0.340, P<0.001; R=0.424, P<0.001). No correlation was observed between fat mass and CSA of median nerve in all groups. We confirmed the enlargement of the median nerve in acromegalic patients. This enlargement is proportional to the degree of IGF-1 levels and is not dependent on the duration of the disease. The enlargement of the median nerve in acromegalic patients also depends on lean body mass and is not dependent on fat body mass.
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Affiliation(s)
- I. Ságová
- Department of Endocrinology, National Institute of Endocrinology and Diabetology, Ľubochňa, Slovakia.
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Ságová I, Pavai D, Kantárová D, Holováčová D, Kužma M, Payer J, Vaňuga P. Influence of Disease Activity and Body Composition Parameters on Cross-Sectional Area of the Median Nerve in Acromegalic Patients. Physiol Res 2021; 70:921-929. [PMID: 34717059 DOI: 10.33549/physiolres.934681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Carpal tunnel syndrome (CTS) is neuropathy that occurs due to compression of the median nerve in the carpal tunnel. Acromegaly is one of the important causes of CTS. The aim of this study was to examine median nerve with ultrasound in acromegalic patients and to assess the relationship with activity, duration of disease and body composition parameters. We prospectively examined the cross-sectional area (CSA) of the median nerve with high-resolution ultrasound in 107 acromegalic patients (70 females and 37 males) and 107 healthy controls (70 females and 37 males) matched for age, gender, and BMI. Body composition parameters were assessed by dual-energy X-ray absorptiometry (DXA). The Student t-tests and Pearson correlation were used for data analysis. The cross sectional area of the median nerve was increased in acromegalic patients compared to controls (11.9 ± 4.8 mm2 vs. 7.7 ± 2.4 mm2, P < 0.001). Positive correlation was found between IGF-1 levels and CSA in the acromegalic group (R = 0.400, P < 0.001). Relationship between CSA and duration of acromegaly was not confirmed. In acromegalic patients, BMI correlated with the CSA (R = 0.294, P = 0.002). There was no significant difference in BMI, fat mass between the acromegalic and control group, but lean mass was higher in acromegalic patients compared with controls (54.8 ± 13.3 vs. 51 ± 11.6, P = 0.047). Lean mass and LMI (total body lean mass/height) positively correlated with CSA in acromegalic patients (R = 0.340, P < 0.001; R = 0.424, P < 0.001). No correlation was observed between fat mass and CSA of median nerve in either group. We confirmed the enlargement of the median nerve in acromegalic patients. This enlargement is proportional to the degree of IGF-1 levels and is not dependent on the duration of the disease. The enlargement of the median nerve in acromegalic patients also depends on lean body mass and is not dependent on fat body mass.
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Affiliation(s)
- I Ságová
- Department of Endocrinology, National Institute of Endocrinology and Diabetology, Ľubochňa, Slovakia.
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Giustina A, Barkan A, Beckers A, Biermasz N, Biller BMK, Boguszewski C, Bolanowski M, Bonert V, Bronstein MD, Casanueva FF, Clemmons D, Colao A, Ferone D, Fleseriu M, Frara S, Gadelha MR, Ghigo E, Gurnell M, Heaney AP, Ho K, Ioachimescu A, Katznelson L, Kelestimur F, Kopchick J, Krsek M, Lamberts S, Losa M, Luger A, Maffei P, Marazuela M, Mazziotti G, Mercado M, Mortini P, Neggers S, Pereira AM, Petersenn S, Puig-Domingo M, Salvatori R, Shimon I, Strasburger C, Tsagarakis S, van der Lely AJ, Wass J, Zatelli MC, Melmed S. A Consensus on the Diagnosis and Treatment of Acromegaly Comorbidities: An Update. J Clin Endocrinol Metab 2020; 105:5586717. [PMID: 31606735 DOI: 10.1210/clinem/dgz096] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/04/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the Acromegaly Consensus Group was to revise and update the consensus on diagnosis and treatment of acromegaly comorbidities last published in 2013. PARTICIPANTS The Consensus Group, convened by 11 Steering Committee members, consisted of 45 experts in the medical and surgical management of acromegaly. The authors received no corporate funding or remuneration. EVIDENCE This evidence-based consensus was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence following critical discussion of the current literature on the diagnosis and treatment of acromegaly comorbidities. CONSENSUS PROCESS Acromegaly Consensus Group participants conducted comprehensive literature searches for English-language papers on selected topics, reviewed brief presentations on each topic, and discussed current practice and recommendations in breakout groups. Consensus recommendations were developed based on all presentations and discussions. Members of the Scientific Committee graded the quality of the supporting evidence and the consensus recommendations using the GRADE system. CONCLUSIONS Evidence-based approach consensus recommendations address important clinical issues regarding multidisciplinary management of acromegaly-related cardiovascular, endocrine, metabolic, and oncologic comorbidities, sleep apnea, and bone and joint disorders and their sequelae, as well as their effects on quality of life and mortality.
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Affiliation(s)
- Andrea Giustina
- Division of Endocrinology and Metabolism, San Raffaele University Hospital, Milan, Italy
| | - Ariel Barkan
- Division of Endocrinology, University of Michigan Health System, Ann Arbor, Michigan
| | - Albert Beckers
- Department of Endocrinology, University of Liège, Liège, Belgium
| | - Nienke Biermasz
- Division of Endocrinology and Center for Endocrine Tumors, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Beverly M K Biller
- Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cesar Boguszewski
- SEMPR, Endocrine Division, Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil
| | - Marek Bolanowski
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Vivien Bonert
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Marcello D Bronstein
- Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo, Sao Paulo, Brazil
| | - Felipe F Casanueva
- Division of Endocrinology, Santiago de Compostela University and Ciber OBN, Santiago de Compostela, Spain
| | - David Clemmons
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Annamaria Colao
- Division of Endocrinologia, Universita' Federico II di Napoli, Naples, Italy
| | - Diego Ferone
- Endocrinology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Maria Fleseriu
- Departments of Medicine and Neurological Surgery, Pituitary Center, Oregon Health & Science University, Portland, Oregon
| | - Stefano Frara
- Division of Endocrinology and Metabolism, San Raffaele University Hospital, Milan, Italy
| | - Monica R Gadelha
- Neuroendocrinology Research Center/Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ezio Ghigo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, Turin, Italy
| | - Mark Gurnell
- University of Cambridge & Addenbrooke's Hospital, Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Cambridge, United Kingdom
| | - Anthony P Heaney
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Ken Ho
- The Garvan Institute of Medical Research and St. Vincent's Hospital, Sydney, Australia
| | - Adriana Ioachimescu
- Department of Medicine, Division of Endocrinology, Metabolism and Lipids, and Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Laurence Katznelson
- Departments of Medicine and Neurosurgery, Stanford University School of Medicine, Stanford, California
| | | | - John Kopchick
- Edison Biotechnology Institute and Department of Biomedical Sciences, Ohio University, Athens, Ohio
| | - Michal Krsek
- 2nd Department of Medicine, 3rd Faculty of Medicine of the Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | | | - Marco Losa
- Department of Neurosurgery, San Raffaele University Health Institute Milan, Milan, Italy
| | - Anton Luger
- Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria
| | - Pietro Maffei
- Department of Medicine, Padua University Hospital, Padua, Italy
| | - Monica Marazuela
- Department of Medicine, CIBERER, Universidad Autónoma de Madrid, Madrid, Spain
| | - Gherardo Mazziotti
- Endocrinology Unit, Humanitas University and Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Moises Mercado
- Division of Medicine, National Autonomous University of Mexico, Experimental Endocrinology Unit, Centro Médico Nacional, Siglo XXI, IMSS, Mexico City, Mexico
| | - Pietro Mortini
- Department of Neurosurgery, San Raffaele University Health Institute Milan, Milan, Italy
| | - Sebastian Neggers
- Pituitary Center Rotterdam, Endocrinology Section, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alberto M Pereira
- Division of Endocrinology and Center for Endocrine Tumors, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Manel Puig-Domingo
- Endocrinology Service, CIBER and CIBERES Germans Trias i Pujol Research Institute and Hospital, Autonomous University of Barcelona, Badalona, Spain
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes, and Metabolism and Pituitary Center, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Ilan Shimon
- Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
| | - Christian Strasburger
- Department of Medicine for Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin, Berlin, Germany
| | - Stylianos Tsagarakis
- Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece
| | - A J van der Lely
- Pituitary Center Rotterdam, Endocrinology Section, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - John Wass
- Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom
| | - Maria Chiara Zatelli
- Section of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Shlomo Melmed
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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Parolin M, Dassie F, Vettor R, Maffei P. Acromegaly and ultrasound: how, when and why? J Endocrinol Invest 2020; 43:279-287. [PMID: 31502218 DOI: 10.1007/s40618-019-01111-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/03/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Acromegaly is a rare disease caused by an excess of growth hormone and insulin-like growth factor 1. It is usually diagnosed because of typical signs such as macroglossia, acral enlargement, jaw prognathism and malocclusion. Systemic complications are a major cause of morbidity and mortality in acromegaly, and many patients remain undiagnosed for several years. Increased ultrasound (US) application in the general population, and including among acromegaly patients, has revealed many suggestive features which, taken together with clinical suspicion, could induce suspicion of this disease. PURPOSE This review describes main US features in acromegaly. Echocardiography shows a typical cardiomyopathy, characterized by left ventricular hypertrophy, diastolic and systolic dysfunction, aortic and mitral regurgitation, and increased aortic root diameters. US preclinical markers of atherosclerosis, such as intima media thickness (IMT), seem also to be impaired. Visceromegaly and increased organ stiffness are other features of acromegaly, including enlarged prostate, kidneys, liver, and thyroid. In addition, other US findings are: renal cysts, micronephrolithiasis, impairment of renal haemodynamic parameters, gallstones and gallbladder polyps, hepatic steatosis, thyroid nodules, multinodular goiter, and polycystic ovaries. Musculoskeletal US findings are increased cartilage thickness, impaired density and elasticity of bones, nerve enlargement, carpal and cubital tunnel syndrome, and trigger finger. CONCLUSIONS Acromegaly patients frequently present systemic complications and a diagnostic delay. US features of acromegaly are not specific, but could potentially have a key role in early detection of the disease in the presence of typical clinical features.
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Affiliation(s)
- M Parolin
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy.
| | - F Dassie
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy
| | - R Vettor
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy
| | - P Maffei
- Clinica Medica 3, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128, Padua, Italy
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Alibas H, Gogas Yavuz D, Kahraman Koytak P, Uygur M, Tanridag T, Uluc K. Peripheral nervous system assessment in acromegaly patients under somatostatin analogue therapy. J Endocrinol Invest 2017; 40:33-40. [PMID: 27484912 DOI: 10.1007/s40618-016-0522-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 07/21/2016] [Indexed: 01/12/2023]
Abstract
PURPOSE Acromegaly is known to affect peripheral nervous system (PNS) causing carpal tunnel syndrome (CTS) and polyneuropathy. The frequency of these disorders and the evaluation methods vary among studies. In the present study, we aimed to examine PNS of acromegaly patients under somatostatin analogue (SSA) therapy. METHODS Forty-eight acromegaly patients (26 F/22 M, 45.58 ± 11.6 years) under SSA treatment and 44 healthy controls (25 F/19 M, 47.46 ± 8.7 years) were assessed by symptom questionnaires, neurologic examination and electrophysiological studies. RESULTS 87.5 % of the acromegaly patients had at least one abnormal finding regarding PNS. With the incorporation of palm-wrist median nerve conduction velocity method, we detected CTS in 50 % of patients. Polyneuropathy was less frequent (29.2 %). Both conditions were independent from the coexisting diabetes mellitus (p = 0.22 for CTS, p = 0.71 for polyneuropathy). Polyneuropathy but not CTS was more common among biochemically uncontrolled acromegaly patients rather than those under control (p = 0.03; p = 0.68, respectively). CONCLUSION Our findings emphasize the high prevalence of peripheral nervous system involvement in acromegaly patients under SSA therapy and importance of neurological evaluation of these patients. Early diagnosis and treatment of the disease may reduce the PNS involvement.
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Affiliation(s)
- H Alibas
- Department of Neurology, Marmara University School of Medicine, Fevzi Cakmak Mah. Muhsin Yazicioglu Cad. No: 10 Pendik, 34899, Istanbul, Turkey.
| | - D Gogas Yavuz
- Section of Endocrinology and Metabolism, Marmara University School of Medicine, Fevzi Cakmak Mah. Muhsin Yazicioglu Cad. No: 10 Pendik, 34899, Istanbul, Turkey
| | - P Kahraman Koytak
- Department of Neurology, Marmara University School of Medicine, Fevzi Cakmak Mah. Muhsin Yazicioglu Cad. No: 10 Pendik, 34899, Istanbul, Turkey
| | - M Uygur
- Section of Endocrinology and Metabolism, Marmara University School of Medicine, Fevzi Cakmak Mah. Muhsin Yazicioglu Cad. No: 10 Pendik, 34899, Istanbul, Turkey
| | - T Tanridag
- Department of Neurology, Marmara University School of Medicine, Fevzi Cakmak Mah. Muhsin Yazicioglu Cad. No: 10 Pendik, 34899, Istanbul, Turkey
| | - K Uluc
- Department of Neurology, Marmara University School of Medicine, Fevzi Cakmak Mah. Muhsin Yazicioglu Cad. No: 10 Pendik, 34899, Istanbul, Turkey
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