Background: In untreated acromegaly patients, decreased cognitive functioning is reported to be associated with the degree of growth hormone (GH) and IGF-1 excess. Whether previous GH excess or current medical treatment for acromegaly specifically affects cognition remains unclear. The aim of this study was to compare cognitive functioning of patients who are treated for acromegaly with patients with non-functioning pituitary adenomas (NFA). In addition, we assessed the influence of prolonged medical treatment after initial transsphenoidal surgery on cognition.
Design: In this cross-sectional study, 74 patients participated, who were treated for acromegaly (n = 50; median [interquartile range] age: 53 [45-65] years) or NFA (n = 24; age: 63 [59-70] years). The NFA patients were selected for a high likelihood of normal GH secretion based on an IGF-1 z-score within the normal range (> -2) and zero or one axis substituted. Of the acromegaly patients, 28 had achieved remission, while 22 were biochemically controlled with long-acting somatostatin analogues and/or pegvisomant. Memory and executive functioning were assessed by the 15 Words Test and the Ruff Figural Fluency Test, and reported as z-scores.
Results: The total patient group scored significantly poorer than the reference population on memory and executive functioning (P < 0·001). However, cognitive test performance was not significantly different between acromegaly patients with a persistent disease, acromegaly patients in remission and NFA patients.
Conclusion: The total patient group scored worse compared with reference populations. We found no association between previous GH excess and cognition. In addition, current medical treatment for GH excess in acromegaly was not related to memory and executive functioning.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1365-2362.2012.02721.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Diagnostic delay, older age, and hormonal levels at diagnosis affect disease burden and mortality in acromegaly.
J Endocrinol Invest
December 2024
Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Science, University of Turin, Turin, Italy.
Purpose: Acromegaly, a rare disease with peak incidence in early adulthood, is marked by significant diagnostic delay and increased mortality due to complications. While older patients often show milder disease activity, they experience longer diagnostic delay. Higher hormonal levels, advanced age, and prolonged delay are associated with more systemic complications.
View Article and Find Full Text PDFTreatment of acromegaly-induced diabetes: an updated proposal.
Pituitary
December 2024
Endocrinology & Nutrition Department, Hospital Universitario Germans Trias i Pujol. CIBERER U747 (ISCIII), Universitat Autònoma de Barcelona, Badalona, Spain.
Acromegaly-induced diabetes presents unique features due to the direct effects of excess growth hormone (GH) and insulin-like growth factor 1 (IGF-) on glucose metabolism, especially insulin resistance in association to low body fat content and water retention. Increased cardiovascular risk is much higher when acromegaly is complicated with diabetes, thus requiring a holistic management that addresses also these specific characteristics which differ from those of classical type 2 diabetes.The optimal management of diabetes in acromegaly requires not only an effective control of carbohydrate disturbances per se, but also the concurrent control of GH hypersecretion as it will directly impact on glucose control.
View Article and Find Full Text PDFAre Oral Somatostatin Receptor Ligands Moving Closer to Becoming a Reality?
Clin Endocrinol (Oxf)
December 2024
Departments of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospital NHS Trust, Leeds, UK.
With the current therapeutic modalities available to endocrinologists, control of GH and IGF-I is now possible in almost all patients with acromegaly with multi-modality therapy. Despite biochemical control of GH and IGF-I, patients with acromegaly continue to experience impaired quality of life. Although there are likely multiple factors contributing to this dissatisfaction with current medical therapies, in particular the widely utilised injectable long-acting somatostatin receptor ligands (iSRL), is a contributor.
View Article and Find Full Text PDFKnowledge and attitudes of primary care physicians regarding acromegaly: a survey study with multinational participation.
BMC Prim Care
December 2024
Department of Internal Medicine, Division of Endocrinology and Metabolism, Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey.
Background: Acromegaly is a disease with high morbidity and mortality rates. The role of primary care physicians is very important in the early diagnosis of acromegaly. The present study aims to determine the knowledge and attitudes of primary care physicians about acromegaly in different countries worldwide.
View Article and Find Full Text PDFPasireotide-induced hyperglycemia in Cushing's disease and Acromegaly: A clinical perspective and algorithms proposal.
Front Endocrinol (Lausanne)
December 2024
Recordati Rare Diseases, Central and Eastern Europe, Warsaw, Poland.
Pasireotide is an effective treatment for both Cushing's disease (CD) and acromegaly due to its ability to suppress adrenocorticotropic hormone and growth hormone, and to normalize insulin-like growth factor-1 levels, resulting in tumor shrinkage. However, it may also cause hyperglycemia as a side effect in some patients. The aim of this study was to review previous recommendations regarding the management of pasireotide-induced hyperglycemia in patients with CD and acromegaly and to propose efficient monitoring and treatment algorithms based on recent evidence and current guidelines for type 2 diabetes treatment.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!