Acromegaly without Diabetes Mellitus as a Clinical Model To Evaluate If Serum High Level Insulin-Like Growth (IGF-1) Factor and Grown Hormone (GH) Would Be Relate to Proliferative Retinotapthy
Abstract Number: 2223-PO
Authors: EDUARDO BREA, LUIS VILLELA, ROSA M. ROMERO.
Institutions: Metepec, Estado de Mexico, Mexico.
Results: BACKGROUND:Acromegaly is a rare disease. Etiology is related to hypophysis adenoma. A biochemical characteristics is high seric level of IGF-1.AIM:Evaluate retrospectively high seric level of IGF-1 and GH in patients with acromegaly de novo without diabetes mellitus and correlate retinal findings and seric level of IGF-1 and GH.METHODS:Patients must fill all criteria for acromegaly diagnosis. All of them were applied to suppression of GH with glucose test and seric levels of IGF-1. When diagnostic was confirmed, then patients were carried out retinal funduscopy and fluorescent angiography. We evaluated to relation among IGF-1and GH versus kind of retinopathy using Fisher´s exact test and estimate relative risk with confidence interval of 95% (CI95%) using multivariated analysis. OUTCOME: Fifteen acromegalic patients were analyzed but seven patients were eliminated of analysis because of diabetes mellitus or incomplete data on registry. Seven patients were analyzed. There were 71.4% males and 28.6% females. Media age at diagnostic was 47.29 year +11.09. Time to diagnostic was a media of 4.5 years SD 1.58, media peak of GH was 7.9 ±1.58, media peak of IGF-1 was 502.6±202.7, media initial glucose was 92±13.2 and media glucose after 120 minutes was 124.2±33.1. All patients in our series had high seric levels of IGF-1 and GH, however proliferative retinopathy was not diagnosed in our series but was observed in three patients (42.9%) changes compatible with macular degeneration. Multivariated analysis showed relative risk for IGF-1 0.80(CI95% 0.14-4.16,p=0.714). CONCLUSIONS: In our clinical model of acromegaly without diabetes mellitus, we observed changes in retinal area but not associated to proliferative retinopathy although high seric levels of IGF-1 were found in all patients. Moreover, relative risk for IGF-1 was not conclusive supporting the theory in relation to retinal vascular proliferation. Then, IGF-1 could be not implicated in vascular proliferation.