DOI: 10.32322/jhsm.1999958 ISSN: 2636-8579

Do growth hormone and insulin-like growth factor-1 reflect metabolic disturbances in acromegaly? A retrospective cohort study

Sadettin Öztürk, Esma Gülsün Arslan Cellat, Burak Erbağcı, Suzan Tabur, Mustafa Araz, Ersin Akarsu
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Aims: To investigate the relationships between serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) concentrations and metabolic parameters, including glucose metabolism and lipid profile, in patients with acromegaly.Methods: This retrospective observational study included 74 patients with acromegaly followed at a tertiary referral center between January 2001 and December 2020. Demographic, hormonal, metabolic, and biochemical data were retrieved from electronic medical records. Correlations between GH, IGF-1, fasting plasma glucose (FPG), glycated hemoglobin (A1c), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and other biochemical parameters were assessed using Spearman’s rank correlation analysis. Gender-specific subgroup analyses and separate multivariable linear regression models were constructed for glucose- and lipid-metabolism outcomes, with GH and standardized IGF-1 values included as the principal explanatory variables.Results: Neither GH nor IGF-1 was significantly associated with FPG, A1c, or lipid profile parameters in the overall cohort. An exploratory unadjusted inverse correlation between IGF-1 ×ULN and HDL-C was observed in female patients (ρ=-0.367, p=0.016), whereas GH showed a borderline negative correlation with vitamin D levels (ρ=-0.301, p=0.050). No significant associations were identified in male patients. Multivariable linear regression analyses showed that neither GH nor standardized IGF-1 was independently associated with the evaluated glucose- or lipid-metabolism outcomes after adjustment for relevant clinical covariates. Of the 74 patients, 41 (55.4%) had biochemically active disease and 33 (44.6%) had controlled/remission disease. Although patients with active disease showed numerically less favorable glucose- and lipid-metabolism profiles, none of the between-group differences in metabolic outcomes reached statistical significance.Conclusion: Circulating GH and IGF-1 concentrations were not independently associated with glucose metabolism or lipid profile parameters in the overall cohort of patients with acromegaly. These findings suggest that metabolic alterations in acromegaly are likely influenced by multiple clinical and biological factors beyond circulating GH and IGF-1 concentrations alone. Larger prospective multicenter studies are needed to validate these findings.

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