Does IGF-1 play a role in the etiopathogenesis of non-functioning adrenocortical adenoma?

PURPOSE: The aim of this study was to investigate the possible association of insulin-like growth factor-1 (IGF-1) with the pathogenesis of non-functioning adrenocortical adenomas (NFAs). METHODS: This study included 50 female patients (mean age 54 years) with NFAs, 55 patients (mean age 48 years; 20 male, 35 female) with acromegaly and 38 female control subjects (mean age 58 years). Body mass index (BMI) and waist circumference (WC) of the subjects were recorded and blood samples for IGF-1 were taken. Insulin resistance was calculated using the homeostatic model assessment (HOMA) score. Since most of the acromegaly patients had been using medicine that could have effected insulin resistance, HOMA scores were calculated only in patients with NFAs and the controls. Computerized tomography or magnetic resonance imaging was taken of the acromegalics and controls to detect adrenal mass frequency. RESULTS: The mean age was similar among the groups. As expected, the serum IGF-1 levels were significantly higher in patients with acromegaly than in patients with NFAs and the controls (p < 0.001). Although BMI, WC, and serum IGF-1 levels were significantly higher (p < 0.001) in patients with NFAs, the HOMA scores were similar between patients with NFAs and control groups. Although none of the control subjects had adrenal masses, NFAs were detected in 14 (25%) out of 55 acromegalic patients. CONCLUSIONS: Higher serum IGF-1 levels in patients with NFAs compared to the control group and an increased prevalence of NFAs in acromegaly patients compared to control subjects and the general population suggest an association of IGF-1 with the etiopathogenesis of NFA.

Assessment of balance performance and fear of falling in acromegalic patients: a comparative study.

BACKGROUND: Acromegaly may lead to balance disturbances and fear of falling due to changes in body composition and co-morbidities. AIM: The aim of this study was to evaluate balance and fear of falling in acromegalic patients and their relation with disease characteristics. MATERIALS AND METHODS: Forty-eight acromegalic patients and 41 age- and gender-matched controls were enrolled in the study. The median ages of the patients and controls were 48 (25-75) and 50 (25-67) yr, respectively. Berg Balance Scale (BBS) and one-leg stance test (OLST) were used to compare dynamic and static balance respectively, 50 meters walking test was used to compare functional capacity and falls efficacy scale-international (FES-I) was used to compare fear of falling between the groups. RESULTS: Balance tests (BBS and 50 meter walking test) and fear of falling (FES-I) were significantly disturbed in patients compared with controls. There was no significant difference in OLST. BBS and OLST were negatively and FES-I was positively correlated with age. FES-I was negatively correlated with BBS and OLST was positively correlated with 50 meters walking test. Only OLST was negatively correlated with disease duration. Logistic regression analysis revealed that balance was not affected by the presence of co-morbidities, postoperative vision loss and disease control. CONCLUSIONS: This is the first study showing that balance is disturbed in acromegalic patients. This disturbance is not related to disease control and co-morbidities but somewhat to disease duration.

Quality of life is impaired not only in vitamin D deficient but also in vitamin D-insufficient pre-menopausal women.

BACKGROUND: Vitamin D deficiency may be more common in pre-menopausal women than previously thought and it may impair quality of life (QoL). AIM: The aim of this study is to evaluate QoL in pre-menopausal women with vitamin D deficiency and insufficiency. SUBJECTS AND METHODS: This is a cross-sectional study in which subjects were enrolled between September 1st and November 30th, 2011. Healthy premenopausal women with weakness, fatigue and non-specific pain were assigned into three groups according to their 25- hydroxyvitamin D (25-OHD) levels: ≤20 ng/ml (vitamin D deficient, no.=30), 21-29 ng/ml (vitamin D insufficient, no.=30) and ≥30 ng/ml (vitamin D sufficient, no.=20). Short form-36 (SF- 36) scores, age, calcium (Ca), phosphorus (P), and PTH levels were compared among the groups and correlations of SF-36 scores with age, serum 25-OHD, Ca, P, and PTH were done. RESULTS: There were significant differences among the groups with regard to PTH (p=0.008), physical component score (p=0.02), mental component score (p=0.035), physical functioning score (p=0.0001), and vitality score (p=0.05). Apart from PTH and physical functioning score, the results were significant when vitamin D-insufficient and -sufficient women were compared. Serum 25-OHD, but not PTH was correlated with some of the scales of SF-36. CONCLUSIONS: Some components of QoL are impaired not only in vitamin D deficient but also in insufficient pre-menopausal women, and impairment is related to 25-OHD rather than PTH levels.