The comprehensive impact on human body induced by resolution of growth hormone excess

Eur J Endocrinol. 2018 Apr;178(4):365-375. doi: 10.1530/EJE-17-0872. Epub 2018 Jan 31.

Abstract

Context: Chronic excess of growth hormone (GH) often leads to systemic complications. The reversibility of these complications after GH resolution is not fully understood.

Objective: To investigate when and to what extent will the comorbidities be ameliorated.

Design: We conducted a prospective study comprising 24 patients with acromegaly, who achieved remission after transsphenoidal surgery. The dynamic changes of endocrine, cardiovascular, respiratory, sleep, bone and morphology parameters were evaluated at enrollment and 1 week, 1 month, 3 months, 6 months and 12 months after surgery.

Results: Random GH dropped by 98.4% at the first day postoperatively. IGF-I index dropped by 50% and 64% at 1 week and 1 month respectively and remained unchanged onwards. Glucose metabolism improved significantly at 1 week and stabilized at 1 month. Testosterone in male patients recovered to normal range since 1 month. Systolic blood pressures dropped markedly at 3 months while diastolic blood pressures fell mildly at later visits. Abnormal lung function showed no improvement. The decrease of bone formation and resorption markers occurred at 1 week and 3 months, respectively. At 1 month, the tongue area declined while the airway volume increased significantly, accompanied with improved obstructive sleep apnea syndrome. Extremities, lips and nasal ala became smaller since 1 week. Liver, kidney and spleen volumes declined by 6.4, 15.9, 9.2%, respectively at 1 month. The volumes of pancreas and adrenal showed no change.

Conclusions: The rapid resolution of excessive GH led to the reversible changes of systemic comorbidities in a time-dependent and organ-specific manner.

MeSH terms

  • Acromegaly / blood*
  • Acromegaly / diagnostic imaging*
  • Acromegaly / surgery
  • Adult
  • Blood Glucose / metabolism*
  • Female
  • Human Growth Hormone / blood*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Young Adult

Substances

  • Blood Glucose
  • Human Growth Hormone

Supplementary concepts

  • Growth hormone excess