Gender Differences in Cardiometabolic Disease and Outcomes in Patients with Acromegaly

Document Type

Conference Proceeding

Publication Date

10-22-2025

Publication Title

J Endocr Soc

Keywords

carbohydrate mixture plus electrolytes, growth hormone, acromegaly, adult, body mass, cardiometabolic risk factor, cardiovascular disease, Caucasian, cavernous sinus, conference abstract, controlled study, cross-sectional study, diagnosis, endocrine disease, female, follow up, gender, glycemic control, human, hyperlipidemia, hypertension, impaired glucose tolerance, major clinical study, male, non insulin dependent diabetes mellitus, obstructive sleep apnea, prevalence, retrospective study, sex difference, systolic blood pressure, systolic hypertension, tertiary care center, tumor diagnosis, tumor volume

Abstract

Background: Acromegaly is a disease due to chronic growth hormone (GH) excess and pathological increase of insulin growth factor (IGF) - 1 levels. This rare endocrine disorder is associated with increased risk of cardiometabolic disease and cardiovascular events. There is limited literature in gender-specific differences in prevalence and outcomes of cardiometabolic disease in patients with acromegaly. Objective: To determine the gender differences in cardiometabolic disease and outcomes in patients with acromegaly. Design: Retrospective cross-sectional study of patients diagnosed with acromegaly over a 28-year period (Jan 1996 - Dec 2024). Setting: Academic primary and tertiary care setting. Main outcomes measured: Prevalence of cardiometabolic disease (hypertension, impaired glycemic control - type 2 diabetes mellitus and prediabetes, hyperlipidemia, obstructive sleep apnea) and cardiovascular events requiring procedural intervention (angioplasty) in patients with acromegaly. Results: In this retrospective study of consecutive 111 acromegaly patients [(59 women (53%) with a median age of 45 years at diagnosis, 85 white (77%), 16 black (14%) and 10 other races (9%)] were included. There was no significant difference in age, body mass index (BMI), tumor size, pre-operative Insulin Growth Factor (IGF) - 1 level and follow up period between men and women with acromegaly. Hypertension [(n=54,49%) men (n=31) vs women (n=23), p=0.03] is the most prevalent cardiometabolic risk factor with a significant gender difference in mean systolic BP (men (116 mmHg) vs women (110mmHg), p = 0.02). There were no significant gender differences in the prevalence of obstructive sleep apnea (n=48, 43%) hyperlipidemia (n=42, 38%), and impaired glycemic control (n=40, 36%). 8 male patients (7%) had cardiovascular events requiring angioplasty. In men, multivariate analysis (age at diagnosis, gender, preop IGF-1 levels, BMI at diagnosis, tumor size, systolic BP at diagnosis, presence of cavernous sinus invasion and need for post-op adjuvant treatment) identified elevated systolic BP > 130mmHg (p=0.03) and presence of cavernous since invasion (p=0.01) as predictors for increased risk of cardiovascular events requiring intervention. Conclusion: Hypertension is the most common cardiometabolic disease in patients with acromegaly, with significantly higher prevalence and systolic BP in men. Male acromegalic patients with higher systolic BP and aggressive disease (cavernous sinus invasion) at presentation are at increased risk of cardiovascular events requiring intervention.

Volume

9

First Page

A819

Last Page

A820

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