Polycystic ovary syndrome preceding the diagnosis of acromegaly: a retrospective study in 97 reproductive-aged women

Reproductive Biology and Endocrinology

Research

Aaron K. Styer¹  Georgios A. Zenonos²  Paul A. Gardner²  Tahereh Orouji Jokar³  Anamil M. Khiyami⁴  Pouneh K. Fazeli⁵  Hussein M. Abdallah⁶ 

[1] Beth Israel Deaconess Medical Center and Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA;CCRM Fertility, Boston, MA, USA;Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA;Neuroendocrinology Unit, Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia;Neuroendocrinology Unit, Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA;University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;

关键词: Acromegaly;    Growth hormone;    Hirsutism;    IGF-1;    Irregular menses;    PCOS;   

DOI  :  10.1186/s12958-023-01057-x

 received in 2022-08-30, accepted in 2023-01-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAcromegaly is a disease of growth hormone excess that results in enlargement of extremities, abnormal glucose and lipid metabolism, and gonadal disruption. Manifestations of the disease are insidious and typically lead to a diagnostic delay of 7–10 years. Classically the polycystic ovary syndrome (PCOS) phenotype is described in women with irregular menses, clinical or biochemical evidence of androgen excess, and/or multiple ovarian follicles on pelvic ultrasonography. Women with acromegaly may present with some or all of these symptoms. Our objective was to evaluate the prevalence of PCOS in patients with acromegaly and to determine if diagnosis of PCOS results in a delay in diagnosing acromegaly.MethodsUsing patient databases at two academic health centers, we identified 97 premenopausal women aged 18–49 years old presenting with acromegaly. Data were collected regarding pelvic sonography and reproductive history, including the diagnosis of PCOS. Patients carrying the diagnosis of PCOS before their diagnosis of acromegaly were identified and the remaining patients were screened using the Rotterdam criteria to identify additional patients meeting thecriteria for PCOS prior to their diagnosis of acromegaly.ResultsMean age of the population (n = 97) at the time of diagnosis of acromegaly was 33.4 ± 7.5 years (SD). Thirty-three percent of patients (n = 32) either carried a diagnosis of PCOS or met diagnostic criteria for PCOS before their diagnosis of acromegaly. In the subset of patients in whom data on symptom onset were available, those who met criteria for PCOS were diagnosed with acromegaly a median of 5 years [4, 9] after the onset of symptoms compared to 2 years [0.92, 3] (p =  0.006) in the patients who did not meet criteria for PCOS.ConclusionsOur data demonstrate a high prevalence of signs and symptoms of PCOS in reproductive-aged women with acromegaly and a longer time to diagnosis in women who meet the clinical criteria for PCOS. As screening for acromegaly is relatively simple and done with measurement of a random, non-fasting IGF-1 level that can be drawn at any time during the menstrual cycle, screening patients with PCOS for acromegaly may lessen the delay in diagnosis for reproductive-aged women with this disease.

【 授权许可】

CC BY   
© The Author(s) 2023