Limits...
The role of diabetes in acromegaly associated neoplasia.

Cheng S, Gomez K, Serri O, Chik C, Ezzat S - PLoS ONE (2015)

Bottom Line: The most frequent anatomic site was the gastrointestinal tract (46 [11.3%]), followed by head and neck (36 [8.8%]) and multiple locations (14 [3.4%]). 106 (26.0%) cases had diabetes.Initial IGF-1 was significantly higher in men older than 50 (380.15 vs. 284.78, p = 0.001) when compared to men younger than 50.Diabetics showed significantly higher initial IGF-1 (389.38 vs. 285.27, p = 0.009), as did diabetics older than 50 compared with those without diabetes. 45.3% (48/106) of cases with diabetes developed extra-pituitary neoplasms vs. 24.3% (71/292) without diabetes (p = 0.001, OR: 2.576 95%CI 1.615-4.108). 22.6% (24/106) of cases with diabetes developed malignant tumors vs. 9.2% (27/292), (p < 0.001, OR 2.873, 95%CI 1.572-5.250).

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Endocrinology and Metabolism, University of Alberta, Edmonton, Alberta, Canada.

ABSTRACT

Background: The risk and mortality due to cancer in patients with acromegaly have been previously investigated. Although GH/IGF-1 excess provides a probable pathophysiological explanation, the degree of IGF-1 excess and the role in acromegaly-associated neoplasms of diabetes, a common comorbidity in acromegaly with known association with cancer, remains unclear.

Methods: Acromegalic patients treated in three Canadian referral centers (Toronto, Montreal, Edmonton) were included. All available clinical information was recorded including: age, initial and last percentage of the upper limit of normal (%ULN) IGF-1 levels, comorbidities and other neoplasms (benign and malignant).

Results: 408 cases were assessed. 185 were women (45.3%), 126 (30.9%) developed extra-pituitary neoplasms: 55 malignant and 71 benign. The most frequent anatomic site was the gastrointestinal tract (46 [11.3%]), followed by head and neck (36 [8.8%]) and multiple locations (14 [3.4%]). 106 (26.0%) cases had diabetes. Initial IGF-1 was significantly higher in men older than 50 (380.15 vs. 284.78, p = 0.001) when compared to men younger than 50. Diabetics showed significantly higher initial IGF-1 (389.38 vs. 285.27, p = 0.009), as did diabetics older than 50 compared with those without diabetes. 45.3% (48/106) of cases with diabetes developed extra-pituitary neoplasms vs. 24.3% (71/292) without diabetes (p = 0.001, OR: 2.576 95%CI 1.615-4.108). 22.6% (24/106) of cases with diabetes developed malignant tumors vs. 9.2% (27/292), (p < 0.001, OR 2.873, 95%CI 1.572-5.250).

Conclusions: These data suggest that acromegalic patients with diabetes are more likely to develop extra-pituitary neoplasms and their initial IGF-1 levels are higher. The contribution of IGF-1 vs. diabetes alone or in combination in the development of extra-pituitary neoplasms warrants further investigation.

No MeSH data available.


Related in: MedlinePlus

Initial and final IGF-1 (%ULN).A. Initial IGF-1 was significantly higher in men (343.82 vs. 277.00, p = 0.001) as was Final IGF-1 (100.77 vs. 81.26, p = 0.022). B. Initial IGF-1 was significantly higher in cases with diabetes (378.50 vs. 284.41, p = 0.001).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4440645&req=5

pone.0127276.g001: Initial and final IGF-1 (%ULN).A. Initial IGF-1 was significantly higher in men (343.82 vs. 277.00, p = 0.001) as was Final IGF-1 (100.77 vs. 81.26, p = 0.022). B. Initial IGF-1 was significantly higher in cases with diabetes (378.50 vs. 284.41, p = 0.001).

Mentions: Both initial (343.8 vs. 277.0, p = 0.001) and final %ULN IGF-1 (100.7 vs. 81.2, p = 0.022) were significantly higher for men when compared to women [Fig 1A].


The role of diabetes in acromegaly associated neoplasia.

Cheng S, Gomez K, Serri O, Chik C, Ezzat S - PLoS ONE (2015)

Initial and final IGF-1 (%ULN).A. Initial IGF-1 was significantly higher in men (343.82 vs. 277.00, p = 0.001) as was Final IGF-1 (100.77 vs. 81.26, p = 0.022). B. Initial IGF-1 was significantly higher in cases with diabetes (378.50 vs. 284.41, p = 0.001).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440645&req=5

pone.0127276.g001: Initial and final IGF-1 (%ULN).A. Initial IGF-1 was significantly higher in men (343.82 vs. 277.00, p = 0.001) as was Final IGF-1 (100.77 vs. 81.26, p = 0.022). B. Initial IGF-1 was significantly higher in cases with diabetes (378.50 vs. 284.41, p = 0.001).
Mentions: Both initial (343.8 vs. 277.0, p = 0.001) and final %ULN IGF-1 (100.7 vs. 81.2, p = 0.022) were significantly higher for men when compared to women [Fig 1A].

Bottom Line: The most frequent anatomic site was the gastrointestinal tract (46 [11.3%]), followed by head and neck (36 [8.8%]) and multiple locations (14 [3.4%]). 106 (26.0%) cases had diabetes.Initial IGF-1 was significantly higher in men older than 50 (380.15 vs. 284.78, p = 0.001) when compared to men younger than 50.Diabetics showed significantly higher initial IGF-1 (389.38 vs. 285.27, p = 0.009), as did diabetics older than 50 compared with those without diabetes. 45.3% (48/106) of cases with diabetes developed extra-pituitary neoplasms vs. 24.3% (71/292) without diabetes (p = 0.001, OR: 2.576 95%CI 1.615-4.108). 22.6% (24/106) of cases with diabetes developed malignant tumors vs. 9.2% (27/292), (p < 0.001, OR 2.873, 95%CI 1.572-5.250).

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Endocrinology and Metabolism, University of Alberta, Edmonton, Alberta, Canada.

ABSTRACT

Background: The risk and mortality due to cancer in patients with acromegaly have been previously investigated. Although GH/IGF-1 excess provides a probable pathophysiological explanation, the degree of IGF-1 excess and the role in acromegaly-associated neoplasms of diabetes, a common comorbidity in acromegaly with known association with cancer, remains unclear.

Methods: Acromegalic patients treated in three Canadian referral centers (Toronto, Montreal, Edmonton) were included. All available clinical information was recorded including: age, initial and last percentage of the upper limit of normal (%ULN) IGF-1 levels, comorbidities and other neoplasms (benign and malignant).

Results: 408 cases were assessed. 185 were women (45.3%), 126 (30.9%) developed extra-pituitary neoplasms: 55 malignant and 71 benign. The most frequent anatomic site was the gastrointestinal tract (46 [11.3%]), followed by head and neck (36 [8.8%]) and multiple locations (14 [3.4%]). 106 (26.0%) cases had diabetes. Initial IGF-1 was significantly higher in men older than 50 (380.15 vs. 284.78, p = 0.001) when compared to men younger than 50. Diabetics showed significantly higher initial IGF-1 (389.38 vs. 285.27, p = 0.009), as did diabetics older than 50 compared with those without diabetes. 45.3% (48/106) of cases with diabetes developed extra-pituitary neoplasms vs. 24.3% (71/292) without diabetes (p = 0.001, OR: 2.576 95%CI 1.615-4.108). 22.6% (24/106) of cases with diabetes developed malignant tumors vs. 9.2% (27/292), (p < 0.001, OR 2.873, 95%CI 1.572-5.250).

Conclusions: These data suggest that acromegalic patients with diabetes are more likely to develop extra-pituitary neoplasms and their initial IGF-1 levels are higher. The contribution of IGF-1 vs. diabetes alone or in combination in the development of extra-pituitary neoplasms warrants further investigation.

No MeSH data available.


Related in: MedlinePlus