Early alterations of lung parenchyma in acromegaly

Background : Acromegaly is an insidious disorder caused by a pituitary growth hormone (GH)-secreting adenoma resulting in high circulating levels of GH and insulin-like growth factor (IGF)-I. Although not common, the lung involvement can severely impact on quality of life, eventually affecting mortality. Methods : We enrolled 10 consecutive patients (M/F: 5/5) affected by acromegaly. Ten healthy age-matched subjects served as controls. All patients underwent clinical, lung functional, biological and radiological assessments. Results : We did not find statistically significant differences in lung function between acromegalic and healthy subjects (p≥ 0.05 for all analyses). However, the KCO% predicted was significantly lower in the acromegalic group than in healthy subjects (p=0.04). In addition, none of the lung function parameters correlated with duration of the disease, nor with inflammatory markers of the airways (FENO and CANO). The total lung volume measured by HRCT was 3540±1555 ml in acromegalics and the mean lung density was -711±73 HU. Lung function variables did not correlate with imaging parameters. However, TLCO% predicted significantly correlated with the lung density evaluated by HRCT (r= 0.70, p=0.03) None of the lung functional, radiological and biological findings correlated with GH or IGF-1 levels and no correlation was found with duration of disease. Conclusions : Lung function evaluation allowed to detect early alterations of lung parenchyma, as assessed by diffusing capacity for CO and HRCT-associated structural alterations of the lung. These findings suggest to routinely evaluate lung function for a proper management of acromegaly.