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IGF-1 is positively associated with BMI in patients with acromegaly

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Abstract

Purpose

Acromegaly is a disorder characterized by IGF-1 excess due to autonomous GH secretion. In individuals without acromegaly, IGF-1 is not only influenced by GH secretion but is also sensitive to other factors including nutritional status, as evidenced by the inverted U-shaped association between BMI and IGF-1; in low-weight individuals (BMI < 18.5 kg/m2) and those who are obese, IGF-1 levels may be frankly low. It is not known if this same relationship between BMI and IGF-1 is also observed in acromegaly.

Methods

Retrospective study including patients who underwent resection of a pituitary adenoma (n = 197) for either acromegaly (n = 32) or a nonfunctioning adenoma (NFPA, n = 165) at a large academic medical center between 1/1/2015 and 5/31/2021.

Results

Median BMI in acromegaly was 30.8 kg/m2 (range 20.9–42.6 kg/m2). Percent upper limit of normal (%ULN) IGF-1 was 228.2% [159.0, 271.4] in acromegaly versus 32.2% [18.5, 50] in NFPA (p < 0.0001). There was a significant positive association between BMI and %ULN IGF-1 (R = 0.35, p < 0.05) in acromegaly. In contrast, there was no association between BMI and %ULN IGF-1 in the NFPA group as a whole (p = 0.22), but a significant inverse association between BMI and %ULN IGF-1 in NFPA patients with a BMI ≥ 35 kg/m2 (rho =  − 0.39, p = 0.02).

Conclusion

In contrast to individuals without acromegaly, BMI is significantly and positively associated with IGF-1 in acromegaly across the weight spectrum. Future studies are needed to determine if obese patients with acromegaly experience more significant symptoms related to their disease, or if patients with a low BMI may require different diagnostic criteria.

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Data availability

Deidentified data will be made available upon reasonable request and with the permission of the University of Pittsburgh institutional review board.

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Authors and Affiliations

  1. Neuroendocrinology Unit, Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Anamil Khiyami, Neha Mehrotra, Sharini Venugopal, Hussain Mahmud & Pouneh K. Fazeli

  2. Department of Clinical Medicine, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

    Anamil Khiyami

  3. Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Georgios A. Zenonos & Paul A. Gardner

Authors
  1. Anamil Khiyami
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  2. Neha Mehrotra
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  3. Sharini Venugopal
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  4. Hussain Mahmud
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  6. Paul A. Gardner
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  7. Pouneh K. Fazeli
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Contributions

Study design: AK and PKF. Data collection/analysis: AK, NM, SV, PKF. First draft of the manuscript was written by AK. All authors critically revised and approved the final manuscript.

Corresponding author

Correspondence to Pouneh K. Fazeli.

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Competing interests

There are no competing interests related to the topic of this manuscript. PKF is a consultant for Regeneron and Xeris Pharmaceuticals.

Ethical approval

This study was approved by the University of Pittsburgh institutional review board.

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Khiyami, A., Mehrotra, N., Venugopal, S. et al. IGF-1 is positively associated with BMI in patients with acromegaly. Pituitary 26, 221–226 (2023). https://doi.org/10.1007/s11102-023-01307-6

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