IGF-1 is positively associated with BMI in patients with acromegaly.

Anamil Khiyami, Neha Mehrotra, Sharini Venugopal, Hussain Mahmud, Georgios A Zenonos, Paul A Gardner, Pouneh K Fazeli

Pituitary 2023 Apr

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Acromegaly is a disorder characterized by IGF-1 excess due to autonomous GH secretion. In individuals without acromegaly, IGF-1 is not only influenced by GH secretion but is also sensitive to other factors including nutritional status, as evidenced by the inverted U-shaped association between BMI and IGF-1; in low-weight individuals (BMI < 18.5 kg/m2) and those who are obese, IGF-1 levels may be frankly low. It is not known if this same relationship between BMI and IGF-1 is also observed in acromegaly. Retrospective study including patients who underwent resection of a pituitary adenoma (n = 197) for either acromegaly (n = 32) or a nonfunctioning adenoma (NFPA, n = 165) at a large academic medical center between 1/1/2015 and 5/31/2021. Median BMI in acromegaly was 30.8 kg/m2 (range 20.9-42.6 kg/m2). Percent upper limit of normal (%ULN) IGF-1 was 228.2% [159.0, 271.4] in acromegaly versus 32.2% [18.5, 50] in NFPA (p < 0.0001). There was a significant positive association between BMI and %ULN IGF-1 (R = 0.35, p < 0.05) in acromegaly. In contrast, there was no association between BMI and %ULN IGF-1 in the NFPA group as a whole (p = 0.22), but a significant inverse association between BMI and %ULN IGF-1 in NFPA patients with a BMI ≥ 35 kg/m2 (rho = - 0.39, p = 0.02). In contrast to individuals without acromegaly, BMI is significantly and positively associated with IGF-1 in acromegaly across the weight spectrum. Future studies are needed to determine if obese patients with acromegaly experience more significant symptoms related to their disease, or if patients with a low BMI may require different diagnostic criteria. © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Citation

Anamil Khiyami, Neha Mehrotra, Sharini Venugopal, Hussain Mahmud, Georgios A Zenonos, Paul A Gardner, Pouneh K Fazeli. IGF-1 is positively associated with BMI in patients with acromegaly. Pituitary. 2023 Apr;26(2):221-226