Clinical Characteristics And Associated Factors Of Colonic Polyps In Acromegaly

Abstract

Purpose: This study investigates the clinical characteristics and the associated factors of colonic polyps in patients with acromegaly.Methods: We retrospectively reviewed clinical characteristics and colonoscopy findings of 86 acromegalic patients who received treatment between August 2015 and July 2020 at Xinqiao Hospital. We analyzed colonoscopy findings and correlation with growth hormone (GH)-secreting pituitary adenoma (GHPA) volume and hormonal/metabolic levels.Results: Our analysis revealed that the prevalence of colonic polyps in acromegalic patients was 40.7% and increased significantly with advanced age, especially ≥50 years. Multiple polyps (62.8%) and colonic polyps in the left colon (54.2%) were detected more frequently. Compared to acromegalic patients without polyps, patients with polyps displayed higher IGF-1×ULN levels (P=0.03). IGF-1 levels and GHPA volumes in patients with polyps showed increasing trends, although there were no significant differences. Meanwhile, patients with polyps in the right colon showed higher GH levels and GH nadir (GHnadir) levels in the oral glucose tolerance test (OGTT) than those with polyps in the whole colon (P=0.023 and P=0.037, respectively). GH levels were higher in patients with polyps diameter ≤5mm than those with polyps diameter >5mm (P=0.031). In addition, the univariate and multivariate logistic regression analysis exhibited 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 acromegalic patients. A nomogram was created to evaluate the risk of colonic polyps in acromegalic patients.Conclusion: The acromegalic patients are a high prevalence population of colonic polyps. Colonic polyps in acromegaly were multiple and frequently detected in the sigmoid colon and rectum. GHPA volumes and IGF-1×ULN levels may be predictors of colonic polyp occurrence.