Akromegali Hastalarında Hematolojik İndekslerin Değerlendirilmesi

Abstract

Objective: Acromegaly is a chronic systemic disease characterized by autonomous and excessive secretion of growth hormone (GH). Acromegaly is most commonly caused by ais a somatotroph adenoma of the anterior pituitary. In acromegaly, mortality primarily results from are cerebrovascular, cardiovascular, respiratory diseases and malignancies. Monocyte/lymphocyte ratio (MLR), neutrophil/lymphocyte ratio (NLR), red cell distribution width (RDW), platelet distribution width (PDW) and delta neutrophil index (DNI) are popular inflammatory markers. This study’s purpose was to assess pre/post-treatment levels of NLR, GH, RDW, MLR, PDW and DNI in acromegalic patients and to investigate the impact of acromegaly treatment on these markers. Materials and Methods: Twenty-six patients with acromegaly, treated and followed at our endocrinology outpatient clinic between April 2014 and February 2022 were included in the study. Age, sex, comorbidities, medications, complete blood count, kidney and liver function tests, pathology reports, tumor size, pre/post-treatment levels of IGF-1, GH, DNI, NLR, MLR, RDW and PDW were retrieved from patients’ files and outcomes were evaluated. Results: Among 26 patients included in the study, 12 (46%) were female and 14 (53%) were male. The average age of the patients was 53.73±16.21 years (range, 25-79). There were 11 (42%) patients with type 2 diabetes mellitus and 9 (34%) patients with hypertension. A statistically significant reduction was observed in post-operative GH, IGF-1, NLR, DNI, PDW and RDW values compared to preoperative values (during active disease phase) and at 6 months in patients with postoperative cure, and compared to pretreatment values in patients without postoperative remission who received medical treatment. A reduction was also observed in post-treatment MLR compared to pretreatment ratio but the difference was non-significant. There was no statistically significant correlation between the IGF-1 levels at the time of diagnosis and NLR, RDW, PDW in patients with acromegaly. Conclusion: Studies on the values of circulating inflammatory biomarkers in patients with acromegaly and their relationship to treatment remain unclear. In our study, higher pre-treatment GH, IGF-1, NLR, DNI, PDW, RDW values were found compared to post- treatment. This suggests that having chronically higher than normal values of IGF-1 may also lead to increased inflammatory markers such as NLR and increased atherosclerotic risk. Chronic subclinical inflammation caused by uncontrolled disease might lead to an increase in mortality and morbidity in acromegalic patients. Therefore, early diagnosis and treatment of acromegaly are crucial.