Clinical Characteristics and Associated Factors of Colonic Polyps in Acromegaly

Abstract

Purpose To investigate the clinical characteristics and associated factors of colonic polyps in patients with acromegaly. Methods Clinical characteristics and colonoscopy findings of 86 acromegaly patients who received treatment were retrospectively reviewed, and colonoscopy findings and the correlation with growth hormone (GH)-secreting pituitary adenoma (GHPA) volume and hormonal/metabolic levels were analyzed. Results The prevalence of colonic polyps in acromegaly patients was 40.7% and increased significantly with advanced age, especially in those ≥50 years. Multiple polyps (62.8%) and colonic polyps in the left colon (54.2%) were detected more frequently. Compared to acromegaly patients without polyps, those with polyps displayed higher insulin-like growth factor-1 × upper limit of normal (IGF-1×ULN) levels (P=0.03). IGF-1 levels and GHPA volumes in patients with polyps showed increasing trends, although the differences were not significant. GH levels were higher in patients with polyps of diameter ≤5 mm than those with polyps of diameter >5 mm (P=0.031). The univariate and multivariate logistic regression analysis revealed that GHPA volumes (OR: 1.09, 95% CI: 1.01–1.20; P=0.039) and IGF-1×ULN Q2 levels (OR: 6.51, 95% CI: 1.20–44.60; P=0.038) were independent factors for predicting the risk of colonic polyp occurrence in acromegaly patients. A nomogram was prepared to evaluate the risk of colonic polyps in acromegaly patients. Conclusion The acromegalic patients are a population with a high prevalence of colonic polyps. GHPA volumes and IGF-1×ULN levels may be predictors of colonic polyp occurrence.

Akromegalik hastaların kolonoskopik değerlendirmesi: tek merkez deneyimi

“…5 Patients with acromegaly had also been found to have an increased incidence of colon polyps. [6][7][8] Earlier and more frequent colonoscopic screening is recommended because the risk of colorectal polyps and cancer is likely to develop earlier in patients with acromegaly than in the general population due to increased GH and IGF-1 levels. Guidelines for the management of acromegaly published by the American Society of Clinical Endocrinologists and the Society of Endocrinology recommend colonoscopy at the time of diagnosis of acromegaly.…”

“…9,10 Some guidelines also state that patients with acromegaly should undergo colonoscopy every 3-5 years, beginning at age forty. 7,11 In this study, we aimed to determine the incidence of colon pathology, specifically colon cancer and colon polyps, the relationship between colon polyp location and pathology, and clinical and laboratory findings in patients with acromegaly who underwent colonoscopy and thus evaluate the need for colonoscopic screening.…”