Anemia in acromegaly: Prevalence, etiologies, and predictors from a large tertiary center cohort
Authors' conclusion
Anemia is a frequent and clinically relevant comorbidity in acromegaly, associated with tumor burden, hypopituitarism, treatment intensity. These findings highlight the need for systematic evaluation of anemia in acromegalic patients and underscore the importance of future prospective studies to clarify its complex pathophysiology.
Study context
- Population
- Patients with acromegaly followed at a tertiary referral center
- Participants
- 381 patients
- Exposure
- Anemic vs non-anemic patients with acromegaly
- Anemian = 219
- Outcome
- Frequency, characteristics and risk factors of anemia
Methodological detailssingle tertiary referral centre
- Single tertiary referral centre
Main finding
As reported in the abstract
Anemia in patients with acromegaly
219 of 381
57.5%
Observational data: associations, not effects.
Further findings
Iron deficiency anaemia by sex
Anaemia characteristics among anaemic patients
- Normocytic
- 67%
- Mild severity
- 45%
- Moderate anaemia
- 11.3%
- Severe anaemia
- 0.8%
- Thalassemia minor
- 4%
- Unexplained anaemia
- 77.3%
- No folate- or vitamin B12-deficiency anaemia observed
Iron deficiency anaemia among anaemic patients
- Iron deficiency anaemia
- 41 of 219 (18.7%)
Microcytic and normocytic anaemia by sex
- Microcytic anaemia in women
- 49/73, 67.1%
- Normocytic anaemia in men
- 74/145, 51.0%
- Normocytic anaemia in women
- 71/145, 49.0%
Anaemic vs non-anaemic patients: tumour, hormonal and treatment features
- Anaemic patients more often had invasive macroadenomas, residual tumour postoperatively and hypopituitarism, with higher postoperative growth hormone (GH), IGF-1 and prolactin levels
- all p < 0.05
- Anaemic patients required more intensive treatment, including somatostatin receptor ligands (SRLs), dopamine agonists and radiotherapy
- Cancer prevalence higher in anaemic patients, not statistically significant
Independent predictors of anaemia (multivariate analysis)
- Macroadenoma, SRL therapy and L-thyroxine use were independent predictors of anaemia
Original publication
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