Background/Objectives: Neoplasms are one of the three most common causes of death in patients with acromegaly. Our study aimed to assess the incidence of benign and malignant neoplasms among patients with acromegaly and the associations between this prevalence and the disease activity, the time of acromegaly diagnosis, and the time of its first symptoms. The correlation between neoplasm occurrence and pituitary somatotropic axis hormone levels was also studied, and the prevalence of different types of neoplasms was compared between the patients with acromegaly and the Polish population. Methods: A retrospective study included a statistical analysis of the medical documentation of 230 patients with acromegaly diagnosed and treated in the Department of Endocrinology, Diabetes, and Isotope Therapy in Wrocław (Poland) between 1976 and 2023. Results: We observed 171 cases of neoplasms (144 benign and 27 malignant). All types of neoplasms and benign tumors were diagnosed more frequently, in both the short and long term, after a diagnosis of acromegaly, but, after a long time, only malignant neoplasms were more frequently diagnosed. In the cases of controlled acromegaly, all types of neoplasms and benign neoplasms were more common than in cases of cured acromegaly. The incidence of neoplasms was higher, regardless of type, in patients with active acromegaly compared to the cured disease. Malignant neoplasms of the thyroid, renal, and stomach type were more common among our subjects compared to the Polish population. Conclusions: This study confirms the association between acromegaly, as well as its activity level and the time from its diagnosis, and the prevalence of neoplasms.

Introduction: Prolonged exposure to pathogenic stress factors leads to multisystemic consumption of the body and adverse changes resulting in the development of allostatic load (AL). Stress plays a crucial role in the pathophysiology of many diseases, including endocrinopathies. The purpose of our study was to evaluate the allostatic load index in patients with pituitary tumours and compare it to a control group. Materials and methods: The study group included 58 patients with hormonally active pituitary tumours and 52 patients without pituitary dysfunction, representing the control group. The AL index (ALI) was calculated based on 16 parameters grouped into the following categories: anthropometric parameters, cardiovascular markers, lipid and carbohydrate metabolism parameters, and inflammatory and hormonal markers. Results: In the group of patients with pituitary tumours, a statistically significantly higher AL index was noticed, regardless of the endocrine function of the adenoma, compared to the control group [7.00 (5.00–9.00) vs. 3.50 (2.00–5.00), p < 0.001]. Age significantly affected the AL index, while no such relationship was observed for education. Analysing specific AL biomarkers, patients with pituitary tumours had significantly higher Body Mass Index (BMI), systolic blood pressure and diastolic blood pressure. Individuals in the study group showed significantly higher levels of insulin, triglycerides and interleukin 6, and significantly lower levels of high-density lipoprotein cholesterol, dehydroepiandrosterone sulphate and albumin, compared to the control group. Conclusions: The results of our study indicate the usefulness of the AL index as an integrated tool for assessing the cumulative impact of stress factors in pituitary diseases. In addition, patients with hormonally active pituitary tumours presented a higher cardio-metabolic risk. It is necessary to analyse the clinimetric data affecting AL, which is the next step of our study.

Polycystic ovary syndrome (PCOS) is associated with reproductive, metabolic, and inflammatory disturbances. Alterations in T-cell subpopulations—particularly increased T helper 17 cells (Th17) and decreased regulatory T cells (Treg)—have been reported in PCOS; however, data on normoandrogenic phenotype D remain limited. Hypoxia-inducible factor 1α (HIF-1α), a key regulator of hypoxic response, also influences immune and metabolic processes and may affect the Treg/Th17 balance. To assess Treg and Th17 abundance, HIF-1α expression within these cells, and their ratios in women with phenotype D PCOS compared with healthy controls. The study included 49 women with phenotype D PCOS and 40 controls comparable in terms of age and BMI. Anthropometric, hormonal, metabolic, and inflammatory parameters were evaluated. Peripheral T-cell subsets and intracellular HIF-1α expression were analyzed by multiparameter flow cytometry. Absolute numbers of Treg and Th17 cells did not differ between groups. However, PCOS patients showed significantly higher Treg/Th17 and HIF-1α-positive Treg/HIF-1α-positive Th17 ratios. HIF-1α-positive Treg cells correlated positively with adiposity and insulin resistance markers; however, after False Discovery Rate (FDR) correction, correlations no longer remained statistically significant. Despite normoandrogenemia, PCOS patients exhibited higher hs-CRP levels. Phenotype D PCOS is characterized by altered immune cell ratios rather than absolute T-cell differences, suggesting distinct immunological features and persistent low-grade inflammation.

DOI: 10.20452/pamw.16680, Published online: February 12, 2024, Authors: Martyna Strzelec, Aleksandra Jawiarczyk-Przybyłowska, Joanna Syrycka, Grzegorz Zieliński, Maria Maksymowicz, Marek Bolanowski

Background/Objectives: Cardiovascular complications are a leading cause of premature mortality in patients with acromegaly. Copeptin (CPP) correlates strongly with plasma osmolality and is regulated by non-osmotic stimuli involved in the pathophysiology of cardiovascular disease. Mid-regional proadrenomedullin (MR-proADM), synthesized mainly in the adrenal medulla, vascular endothelial cells, and the heart, has vasodilatory effects. The study aimed to assess two cardiovascular biomarkers (CPP and MR-proADM) in acromegaly patients in relation to disease activity and compare findings with a control group. Methods: The study examined CPP and MR-proADM levels alongside hormonal and biochemical parameters and cardiovascular and metabolic disease prevalence in 53 acromegaly patients and 26 controls. Results: No significant differences in CPP or MR-proADM concentrations were observed between the two groups. However, a positive correlation occurred between growth hormone (GH) and CPP concentrations, and there was a negative correlation between fasting glucose and CPP concentrations in acromegaly patients. The study also found a positive correlation between low-density lipoprotein (LDL) cholesterol and MR-proADM concentrations and between high-density lipoprotein (HDL) cholesterol and MR-proADM levels in the study group. Moreover, atherogenic dyslipidemia was significantly more common in the active form of acromegaly and pituitary macroadenoma patients than in the control group. Acromegaly patients had significantly higher fasting glucose and fasting insulin levels compared to controls, and the homeostasis model assessment of the insulin resistance (HOMA-IR) index was significantly lower in the study group than in the controls. Conclusions: Neither CPP or MR-proADM are significant diagnostic or monitoring indicators of cardiovascular or metabolic complications in acromegaly.