Systemic comorbidities of acromegaly in real-life experience: which difference among young and elderly patients?

Introduction Acromegaly is a rare but potentially life-threatening disease, if not promptly managed, for the systemic complications due to the GH/IGF-I hypersecretion. According to the increased population life span, the number of older acromegaly patients is growing. We aim to investigate clinical features of elderly acromegaly (elderly-ACRO) and to identify the risk factors for the occurrence of comorbidities in elderly-ACRO. Materials and methods A retrospective and multi-center study was performed on acromegaly patients. Acromegaly comorbidities were compared among elderly-ACRO (>65 years), young acromegaly patients (young-ACRO if <= 65 years) and a control group of age and gender-matched subjects. Result Fifty of the 189 enrolled patients were elderly-ACRO (26.5%). Cardiovascular, metabolic, neurological/psychiatric and joint/articular disorders, nodular thyroid disease, sleep apnoea syndrome and skeletal fragility occurred more frequently in elderly-ACRO as compared to controls. Cardiovascular and metabolic disorders, nodular thyroid disease occurred significantly more frequently in elderly-ACRO as compared to young-ACRO and controls. On the other hand, neurological/psychiatric, joint/articular disorders and bone fragility occur with a similar frequency among elderly and young-ACRO. We found that elderly-ACRO had an increased risk for the occurrence of systemic arterial hypertension (p < 0.001, OR: 5.4 95%IC:2.6-10.9), left ventricular hypertrophy (p = 0.01, OR: 3 95%IC: 1.5-5.8) and metabolic disorders (p = 0.006, OR: 4.1 95%IC: 2-8.3). Conclusion Our results may suggest that some acromegaly comorbidities may be predominantly due to acromegaly per-se rather than to aging. On the contrary, cardiovascular and metabolic disorders seem to be due to aging as well.

Automated summary

According to the study, elderly acromegaly patients are more prone to cardiovascular, metabolic, neurological/psychiatric, and joint/articular disorders, as well as nodular thyroid disease. They also have a higher risk of systemic arterial hypertension, left ventricular hypertrophy, and metabolic disorders.