Prostatic hyperplasia: An unknown feature of acromegaly

Annamaria Colao, Paolo Marzullo, Diego Ferone, Stefano Spiezia, Gaetana Cerbone, Valeria Marinò, Antonella Di Sarno, Bartolomeo Merola, Gaetano Lombardi

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

This study was designed to investigate whether GH and insulin-like growth factor I (IGF-I) excess could lead to the development of benign prostatic hyperplasia and/or prostatic carcinoma. Prostatic diameters and volume as well as the occurrence of prostatic diseases were studied by ultrasonography in 10 untreated acromegalic patients less than 40 yr of age and 10 age- and body mass index-matched healthy males. Serum GH, IGF-I, PRL, testosterone, dihydrotestosterone, prostate-specific antigen, and prostatic acid phosphatase levels were assessed. All patients had secondary hypogonadism, as diagnosed by low testosterone levels, and 4 of 10 patients had hyperprolactinemia. After 1 yr of treatment with octreotide (0.3-0.6 mg/day), ultrasound scan and hormone parameters were repeated. The 4 hyperprolactinemic acromegalics were treated with octreotide and cabergoline (1-2 mg/week) to suppress PRL levels. Symptoms due to prostatic, seminal vesicle, and/or urethral disorders or obstruction were experienced by neither acromegalics nor controls. Digital rectal examination revealed no occurrence of prostatic nodules or other abnormalities. Compared to healthy subjects, a remarkable increase in transversal prostatic diameter and volume was observed in acromegalics. In healthy subjects, prostate volume ranged from 15.1-21.8 mL, whereas in acromegalics it ranged from 21.8-41.8 mL. Similarly, an increased median lobe was observed. In fact, the transitional zone diameter was just detectable in 5 of 10 controls, whereas it was measurable in all acromegalics (18 ± 1.2 vs. 2.8 ± 0.3 mm; P <0.001). The prevalence of periurethral calcifications was more than doubled in acromegalics (50%) compared to that in controls (20%). Treatment with octreotide for 1 yr produced normalization of circulating GH and IGF-I levels in 7 of 10 patients. In these 7 patients, ultrasound evaluation showed a significant reduction of the antero-posterior diameter (26.1 ± 1 vs. 28.9 ± 1.6 mm; P <0.01), the transversal diameter (44.9 ± 2 vs, 48 ± 2 mm; P <0.01), and the cranio-caudal diameter (36.5 ± 1 vs. 41.3 ± 1.5 mm; P <0.001), whereas the transitional zone diameter was unchanged (16.4 ± 1.5 vs. 17.4 ± 1.7 mm). As a consequence, a significant decrease in prostate volume was recorded (22.1 ± 1.1 vs. 29.8 ± 2.5 mL; P <0.001). Prostate volume increased in 2 of the 3 patients who did not achieve normalization of GH and IGF-I after octreotide treatment. Finally, after treatment, serum testosterone levels were significantly increased (from 1.5 ± 0.3 to 3.5 ± 0.3 μg/L), whereas dihydrotestosterone, dehydroepiandrosterone sulfate, Δ4-androstenedione, 17β-estradiol, prostate-specific antigen, and prostatic acid phosphatase were unchanged. Serum PRL levels were suppressed after cabergoline treatment in all 4 hyperprolactinemic patients throughout the study period. In conclusion, prostate enlargement occurs in young acromegalics with a higher than expected prevalence of micro- and macrocalcifications. This suggests that a careful prostate screening should be included in the work-up and follow-up of acromegalic males.

Original languageEnglish
Pages (from-to)775-779
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume83
Issue number3
DOIs
Publication statusPublished - 1998

Fingerprint

Acromegaly
Octreotide
Prostatic Hyperplasia
Insulin-Like Growth Factor I
Testosterone
Prostate
Dihydrotestosterone
Prostate-Specific Antigen
Ultrasonics
Ultrasonography
Dehydroepiandrosterone Sulfate
Androstenedione
Healthy Volunteers
Serum
Estradiol
Screening
Prostatic Diseases
Therapeutics
Calcinosis
Digital Rectal Examination

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Prostatic hyperplasia : An unknown feature of acromegaly. / Colao, Annamaria; Marzullo, Paolo; Ferone, Diego; Spiezia, Stefano; Cerbone, Gaetana; Marinò, Valeria; Di Sarno, Antonella; Merola, Bartolomeo; Lombardi, Gaetano.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 83, No. 3, 1998, p. 775-779.

Research output: Contribution to journalArticle

Colao, A, Marzullo, P, Ferone, D, Spiezia, S, Cerbone, G, Marinò, V, Di Sarno, A, Merola, B & Lombardi, G 1998, 'Prostatic hyperplasia: An unknown feature of acromegaly', Journal of Clinical Endocrinology and Metabolism, vol. 83, no. 3, pp. 775-779. https://doi.org/10.1210/jc.83.3.775
Colao, Annamaria ; Marzullo, Paolo ; Ferone, Diego ; Spiezia, Stefano ; Cerbone, Gaetana ; Marinò, Valeria ; Di Sarno, Antonella ; Merola, Bartolomeo ; Lombardi, Gaetano. / Prostatic hyperplasia : An unknown feature of acromegaly. In: Journal of Clinical Endocrinology and Metabolism. 1998 ; Vol. 83, No. 3. pp. 775-779.
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abstract = "This study was designed to investigate whether GH and insulin-like growth factor I (IGF-I) excess could lead to the development of benign prostatic hyperplasia and/or prostatic carcinoma. Prostatic diameters and volume as well as the occurrence of prostatic diseases were studied by ultrasonography in 10 untreated acromegalic patients less than 40 yr of age and 10 age- and body mass index-matched healthy males. Serum GH, IGF-I, PRL, testosterone, dihydrotestosterone, prostate-specific antigen, and prostatic acid phosphatase levels were assessed. All patients had secondary hypogonadism, as diagnosed by low testosterone levels, and 4 of 10 patients had hyperprolactinemia. After 1 yr of treatment with octreotide (0.3-0.6 mg/day), ultrasound scan and hormone parameters were repeated. The 4 hyperprolactinemic acromegalics were treated with octreotide and cabergoline (1-2 mg/week) to suppress PRL levels. Symptoms due to prostatic, seminal vesicle, and/or urethral disorders or obstruction were experienced by neither acromegalics nor controls. Digital rectal examination revealed no occurrence of prostatic nodules or other abnormalities. Compared to healthy subjects, a remarkable increase in transversal prostatic diameter and volume was observed in acromegalics. In healthy subjects, prostate volume ranged from 15.1-21.8 mL, whereas in acromegalics it ranged from 21.8-41.8 mL. Similarly, an increased median lobe was observed. In fact, the transitional zone diameter was just detectable in 5 of 10 controls, whereas it was measurable in all acromegalics (18 ± 1.2 vs. 2.8 ± 0.3 mm; P <0.001). The prevalence of periurethral calcifications was more than doubled in acromegalics (50{\%}) compared to that in controls (20{\%}). Treatment with octreotide for 1 yr produced normalization of circulating GH and IGF-I levels in 7 of 10 patients. In these 7 patients, ultrasound evaluation showed a significant reduction of the antero-posterior diameter (26.1 ± 1 vs. 28.9 ± 1.6 mm; P <0.01), the transversal diameter (44.9 ± 2 vs, 48 ± 2 mm; P <0.01), and the cranio-caudal diameter (36.5 ± 1 vs. 41.3 ± 1.5 mm; P <0.001), whereas the transitional zone diameter was unchanged (16.4 ± 1.5 vs. 17.4 ± 1.7 mm). As a consequence, a significant decrease in prostate volume was recorded (22.1 ± 1.1 vs. 29.8 ± 2.5 mL; P <0.001). Prostate volume increased in 2 of the 3 patients who did not achieve normalization of GH and IGF-I after octreotide treatment. Finally, after treatment, serum testosterone levels were significantly increased (from 1.5 ± 0.3 to 3.5 ± 0.3 μg/L), whereas dihydrotestosterone, dehydroepiandrosterone sulfate, Δ4-androstenedione, 17β-estradiol, prostate-specific antigen, and prostatic acid phosphatase were unchanged. Serum PRL levels were suppressed after cabergoline treatment in all 4 hyperprolactinemic patients throughout the study period. In conclusion, prostate enlargement occurs in young acromegalics with a higher than expected prevalence of micro- and macrocalcifications. This suggests that a careful prostate screening should be included in the work-up and follow-up of acromegalic males.",
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T1 - Prostatic hyperplasia

T2 - An unknown feature of acromegaly

AU - Colao, Annamaria

AU - Marzullo, Paolo

AU - Ferone, Diego

AU - Spiezia, Stefano

AU - Cerbone, Gaetana

AU - Marinò, Valeria

AU - Di Sarno, Antonella

AU - Merola, Bartolomeo

AU - Lombardi, Gaetano

PY - 1998

Y1 - 1998

N2 - This study was designed to investigate whether GH and insulin-like growth factor I (IGF-I) excess could lead to the development of benign prostatic hyperplasia and/or prostatic carcinoma. Prostatic diameters and volume as well as the occurrence of prostatic diseases were studied by ultrasonography in 10 untreated acromegalic patients less than 40 yr of age and 10 age- and body mass index-matched healthy males. Serum GH, IGF-I, PRL, testosterone, dihydrotestosterone, prostate-specific antigen, and prostatic acid phosphatase levels were assessed. All patients had secondary hypogonadism, as diagnosed by low testosterone levels, and 4 of 10 patients had hyperprolactinemia. After 1 yr of treatment with octreotide (0.3-0.6 mg/day), ultrasound scan and hormone parameters were repeated. The 4 hyperprolactinemic acromegalics were treated with octreotide and cabergoline (1-2 mg/week) to suppress PRL levels. Symptoms due to prostatic, seminal vesicle, and/or urethral disorders or obstruction were experienced by neither acromegalics nor controls. Digital rectal examination revealed no occurrence of prostatic nodules or other abnormalities. Compared to healthy subjects, a remarkable increase in transversal prostatic diameter and volume was observed in acromegalics. In healthy subjects, prostate volume ranged from 15.1-21.8 mL, whereas in acromegalics it ranged from 21.8-41.8 mL. Similarly, an increased median lobe was observed. In fact, the transitional zone diameter was just detectable in 5 of 10 controls, whereas it was measurable in all acromegalics (18 ± 1.2 vs. 2.8 ± 0.3 mm; P <0.001). The prevalence of periurethral calcifications was more than doubled in acromegalics (50%) compared to that in controls (20%). Treatment with octreotide for 1 yr produced normalization of circulating GH and IGF-I levels in 7 of 10 patients. In these 7 patients, ultrasound evaluation showed a significant reduction of the antero-posterior diameter (26.1 ± 1 vs. 28.9 ± 1.6 mm; P <0.01), the transversal diameter (44.9 ± 2 vs, 48 ± 2 mm; P <0.01), and the cranio-caudal diameter (36.5 ± 1 vs. 41.3 ± 1.5 mm; P <0.001), whereas the transitional zone diameter was unchanged (16.4 ± 1.5 vs. 17.4 ± 1.7 mm). As a consequence, a significant decrease in prostate volume was recorded (22.1 ± 1.1 vs. 29.8 ± 2.5 mL; P <0.001). Prostate volume increased in 2 of the 3 patients who did not achieve normalization of GH and IGF-I after octreotide treatment. Finally, after treatment, serum testosterone levels were significantly increased (from 1.5 ± 0.3 to 3.5 ± 0.3 μg/L), whereas dihydrotestosterone, dehydroepiandrosterone sulfate, Δ4-androstenedione, 17β-estradiol, prostate-specific antigen, and prostatic acid phosphatase were unchanged. Serum PRL levels were suppressed after cabergoline treatment in all 4 hyperprolactinemic patients throughout the study period. In conclusion, prostate enlargement occurs in young acromegalics with a higher than expected prevalence of micro- and macrocalcifications. This suggests that a careful prostate screening should be included in the work-up and follow-up of acromegalic males.

AB - This study was designed to investigate whether GH and insulin-like growth factor I (IGF-I) excess could lead to the development of benign prostatic hyperplasia and/or prostatic carcinoma. Prostatic diameters and volume as well as the occurrence of prostatic diseases were studied by ultrasonography in 10 untreated acromegalic patients less than 40 yr of age and 10 age- and body mass index-matched healthy males. Serum GH, IGF-I, PRL, testosterone, dihydrotestosterone, prostate-specific antigen, and prostatic acid phosphatase levels were assessed. All patients had secondary hypogonadism, as diagnosed by low testosterone levels, and 4 of 10 patients had hyperprolactinemia. After 1 yr of treatment with octreotide (0.3-0.6 mg/day), ultrasound scan and hormone parameters were repeated. The 4 hyperprolactinemic acromegalics were treated with octreotide and cabergoline (1-2 mg/week) to suppress PRL levels. Symptoms due to prostatic, seminal vesicle, and/or urethral disorders or obstruction were experienced by neither acromegalics nor controls. Digital rectal examination revealed no occurrence of prostatic nodules or other abnormalities. Compared to healthy subjects, a remarkable increase in transversal prostatic diameter and volume was observed in acromegalics. In healthy subjects, prostate volume ranged from 15.1-21.8 mL, whereas in acromegalics it ranged from 21.8-41.8 mL. Similarly, an increased median lobe was observed. In fact, the transitional zone diameter was just detectable in 5 of 10 controls, whereas it was measurable in all acromegalics (18 ± 1.2 vs. 2.8 ± 0.3 mm; P <0.001). The prevalence of periurethral calcifications was more than doubled in acromegalics (50%) compared to that in controls (20%). Treatment with octreotide for 1 yr produced normalization of circulating GH and IGF-I levels in 7 of 10 patients. In these 7 patients, ultrasound evaluation showed a significant reduction of the antero-posterior diameter (26.1 ± 1 vs. 28.9 ± 1.6 mm; P <0.01), the transversal diameter (44.9 ± 2 vs, 48 ± 2 mm; P <0.01), and the cranio-caudal diameter (36.5 ± 1 vs. 41.3 ± 1.5 mm; P <0.001), whereas the transitional zone diameter was unchanged (16.4 ± 1.5 vs. 17.4 ± 1.7 mm). As a consequence, a significant decrease in prostate volume was recorded (22.1 ± 1.1 vs. 29.8 ± 2.5 mL; P <0.001). Prostate volume increased in 2 of the 3 patients who did not achieve normalization of GH and IGF-I after octreotide treatment. Finally, after treatment, serum testosterone levels were significantly increased (from 1.5 ± 0.3 to 3.5 ± 0.3 μg/L), whereas dihydrotestosterone, dehydroepiandrosterone sulfate, Δ4-androstenedione, 17β-estradiol, prostate-specific antigen, and prostatic acid phosphatase were unchanged. Serum PRL levels were suppressed after cabergoline treatment in all 4 hyperprolactinemic patients throughout the study period. In conclusion, prostate enlargement occurs in young acromegalics with a higher than expected prevalence of micro- and macrocalcifications. This suggests that a careful prostate screening should be included in the work-up and follow-up of acromegalic males.

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